Environmental risk factors of nosocomial infection in neurological intensive care unit

Abstract

To evaluate risk factors and methods of infection control in surgical site infections in postoperative neurosurgical patients. Methods: This study was prospective, uncontrolled and observational study conducted on patients with postoperative neurosurgical operation and admitted to ICU postoperatively. The study was done in Al-Azhar university hospitals from March 2017-March 2018. The study aim was to evaluate risk factors and methods of infection control in surgical site infections in postoperative neurosurgical patients. Analysis of data was done by IBM computer using SPSS (statistical program for social science version 25). Results: The mean age and standard deviation (SD) were 42.5 years ±19.1. Female patients were about 40%. Most male patient were above median age of the sample (37.8 years). The overall admission period includes pre-ICU admission, ICU admission and post-ICU admission. The mean and standard deviation of overall admission was 43.7 day±5.5. From the whole study sample, nosocomial infection was estimated to be 88.4% of cases (69 patients). Postoperative mortality among cases was 36%. The rest of cases were either referred or discharged to ward. Comorbid conditions may present as single factor or multiple factors in the same patient. Patients with nosocomial infections were found to have 2 or more comorbid conditions while infection-free cases were found to have no or at least one factor in a statistically significant association. It has been found that most cases with traumatic brain injury and hemorrhagic stroke had nosocomial infection (74%). Both types mentioned previously had had longer ICU stay. It has been found that nosocomial infection is commonly predominant in TBI and ICH cases with statistically significant value (p=0.00005). Nosocomial infections were found to be either single or multiple infections in the same person. Most of infections were; respiratory tract infection, urinary tract infection or septicemia. When the entire study population was subjected to logistic regression analysis, age, diagnosis and hospital stay, necessity for ventilation, low GCS, high temperature, high humidity and low karnofsky were found to be significantly independently predictive of postoperative nosocomial infection. Among these patients, type and timing of operative intervention and environmental factors