title: Neurosurgical Site Infection Prevention: Single Institute Experience.
abstract: OBJECTIVE
  To estimate the effect of a multimodal prevention program on controlling surgical site infection (SSI) risk among neurosurgical patients.
  
  
  METHODS
  This prospective study was conducted among adult patients who have undergone neurosurgical procedures in a tertiary-care university-affiliated hospital during January 2008 to December 2013 since the implementation of an infection control program. SSI cases among inpatients were identified by daily active searches, whereas post-discharge surveillance was performed for outpatients through telephone contact 30-35 days after surgery, according to the definition proposed by the Center for Disease Control. The variation of SSI rate during the study period was analyzed by Cochran-Armitage trend test.
  
  
  RESULTS
  Overall, a total of 3042 patients were enrolled and 112 SSI cases were identified during the studied period. SSI more likely occurred in patients with older age (t=5.16, p < 0.01), undergoing emergency operations (x2=50.5, p < 0.01), having higher American Society of Anesthesiologists (ASA) scores (x2=7.2, p=0.01) and clean contaminated wound or above (x2=53.8, p < 0.01). The annual incidence rate of SSI was 6.21%, 5.01%, 3.89%, 3.06%, 2.38% and 2.28%, respectively, showing a significant decreasing trend (z=3.96, p < 0.01).
  
  
  CONCLUSIONS
  The results provide evidence of a significant decreasing trend in the SSI rate following the infection prevention program, demonstrating the role of multimodal approach in controlling SSI.
authors.affiliation: Tangdu Hospital , The Fourth Military Medical University, Department of Neurosurgery, Xi'an, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Jiang
authors.forename: Jianjun
authors.initials: J
authors.lastname: Ma
authors.forename: Fang
authors.initials: F
authors.lastname: Hou
authors.forename: Juan
authors.initials: J
authors.lastname: Li
authors.forename: Ruigang
authors.initials: R
authors.lastname: Li
authors.forename: Hongjuan
authors.initials: H
authors.lastname: Lang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control*