Frequency and risk factors of Surgical Site Infections following neurosurgical procedures.

Abstract

Objective: To determine the frequency and identify risk factors associated with SSIs following neurosurgical procedures. Study Design: Analytical Cross-sectional Investigation. Setting: Neurosurgery Department of Nishtar Hospital Multan. Period: May 2025 to January 2026. Methods: Following ethical approval, 292 patients undergoing cranial or spinal procedures were enrolled. Data included demographics, comorbidities, procedural details and microbiological profiles. Infections were classified using CDC criteria. SPSS version 23.0 analyzed data. Chi-square and Independent sample t-tests were used to assess the associations and p value <0.05 taken as significant. Results: Among 287 patients overall SSI frequency was 5.2%. Significant risk factors included diabetes mellitus (OR 4.89), obesity (OR 3.42), emergency surgery (OR 3.78), operative duration exceeding 180 minutes (OR 5.08), and delayed antibiotic prophylaxis (OR 3.69). Staphylococcus aureus was the predominant pathogen (40%), with 50% methicillin resistance. Gram-negative organisms included Escherichia coli and Pseudomonas. Infected patients experienced prolonged hospital stays (18 vs 6 days), higher reoperation rates (73.3% vs 4.4%), and increased 90-day mortality (13.3% vs 1.1%), respectively. Conclusion: SSIs constitute a major preventable complication driven by modifiable patient and procedural risk factors. Implementing standardized prevention protocols alongside robust antimicrobial stewardship is essential to reduce morbidity, mortality and healthcare costs in resource constrained settings.