Abstract：
BACKGROUND: To investigate the clinical features and risk factors of ventriculoperitoneal shunt (VPS) associated surgical site infections (SSIs) in HIV-negative patients with cryptococcal meningitis (CM).
METHODS: We retrospectively reviewed the medical records of HIV-negative patients with CM underwent VPS operation admitted to The Third Affiliated Hospital of Sun Yat-sen University in Southwest China over the past 7 years.
RESULTS: 193 patients were included, of whom 25 (12.95%) had SSIs in 6 (median duration, 1-48 days) days after operation. Compared with patients without SSIs, patient with SSIs tended to be shorter preoperative stay. 52% patients in SSIs group and 25% patients in no-SSIs group underwent VPS operations within 3 days after admission (p = 0.017). Although body temperature and infectious indicators slightly elevated postoperative in both groups. The patients with SSIs experienced more fever; more central nervous system symptoms; higher PCT value and lower cerebrospinal fluid (CSF) glucose in contrast to the no-SSIs group. Multivariate regression analysis found a 2.653 fold increase in the risk of infection for every 1 °C increase in postoperative body temperature. Among the 25 patients, 9 patients had positive culture results, three samples reported to be oxacillin resistant coagulase-negative Staphylococci.
CONCLUSIONS: SSIs was one of the serious surgical complications after VPS operation. High body temperature, the occurrence of dizziness and headache, low postoperative hemoglobin are risk factors. Postoperative patients with high fever, high PCT and low CSF glucose should be paid more attention to.
METHODS: We retrospectively reviewed the medical records of HIV-negative patients with CM underwent VPS operation admitted to The Third Affiliated Hospital of Sun Yat-sen University in Southwest China over the past 7 years.
RESULTS: 193 patients were included, of whom 25 (12.95%) had SSIs in 6 (median duration, 1-48 days) days after operation. Compared with patients without SSIs, patient with SSIs tended to be shorter preoperative stay. 52% patients in SSIs group and 25% patients in no-SSIs group underwent VPS operations within 3 days after admission (p = 0.017). Although body temperature and infectious indicators slightly elevated postoperative in both groups. The patients with SSIs experienced more fever; more central nervous system symptoms; higher PCT value and lower cerebrospinal fluid (CSF) glucose in contrast to the no-SSIs group. Multivariate regression analysis found a 2.653 fold increase in the risk of infection for every 1 °C increase in postoperative body temperature. Among the 25 patients, 9 patients had positive culture results, three samples reported to be oxacillin resistant coagulase-negative Staphylococci.
CONCLUSIONS: SSIs was one of the serious surgical complications after VPS operation. High body temperature, the occurrence of dizziness and headache, low postoperative hemoglobin are risk factors. Postoperative patients with high fever, high PCT and low CSF glucose should be paid more attention to.
摘要：
背景：探讨HIV阴性隐球菌性脑膜炎（CM）患者脑室-腹腔分流术（VPS）相关手术部位感染（SSIs）的临床特征和危险因素。
方法：回顾性分析了中国西南地区中山大学附属第三医院收治的HIV阴性CM患者在过去7年中接受VPS手术的病历。
结果：纳入193例患者，其中25人(12.95%)在6人中有SSIs(中位持续时间，术后1-48天)。与没有SSIs的患者相比，SSIs患者的术前住院时间往往较短。SSIs组52％的患者和无SSIs组25％的患者在入院后3天内接受了VPS手术（p=0.017）。虽然两组患者术后体温和感染指标略有升高。与无SSIs组相比，患有SSIs的患者发烧更多；中枢神经系统症状更多；PCT值较高，脑脊液（CSF）葡萄糖较低。多因素回归分析发现，术后体温每升高1°C，感染风险增加2.653倍。在25名患者中，9例培养结果呈阳性，3个样本报告为耐苯唑西林凝固酶阴性葡萄球菌。
结论：SSIs是VPS术后严重的手术并发症之一。体温高,头晕和头痛的发生，术后血红蛋白低是危险因素。术后患者高热，高PCT和低CSF葡萄糖应引起重视。
方法：回顾性分析了中国西南地区中山大学附属第三医院收治的HIV阴性CM患者在过去7年中接受VPS手术的病历。
结果：纳入193例患者，其中25人(12.95%)在6人中有SSIs(中位持续时间，术后1-48天)。与没有SSIs的患者相比，SSIs患者的术前住院时间往往较短。SSIs组52％的患者和无SSIs组25％的患者在入院后3天内接受了VPS手术（p=0.017）。虽然两组患者术后体温和感染指标略有升高。与无SSIs组相比，患有SSIs的患者发烧更多；中枢神经系统症状更多；PCT值较高，脑脊液（CSF）葡萄糖较低。多因素回归分析发现，术后体温每升高1°C，感染风险增加2.653倍。在25名患者中，9例培养结果呈阳性，3个样本报告为耐苯唑西林凝固酶阴性葡萄球菌。
结论：SSIs是VPS术后严重的手术并发症之一。体温高,头晕和头痛的发生，术后血红蛋白低是危险因素。术后患者高热，高PCT和低CSF葡萄糖应引起重视。
