Surgical site infection (SSI) after craniotomy for primary CNS tumors can have detrimental consequences by delaying chemoradiation treatment. The authors performed a retrospective chart review of all patients who underwent craniotomies for resection of primary brain tumors at the Moffitt Cancer Center from 2004–2014. Multivariate logistic analysis was used to identify independent risk factors. A total of 864 patients underwent craniotomies for primary brain tumors, but 65 were excluded due to insufficient followup or incomplete records. We identified 30 patients with SSI (3.8%). The most common microorganisms isolated from SSI were methicillin resistant Staphylococcus aureus (40%), methicillin sensitive Staphylococcus aureus (17%), methicillin resistant Streptococcus epidermidis (7%), Pseudomonas (7%), Enterobacteriaceae (7%), and E coli (7%). During the latter part of this time period, we initiated a program of intraoperative topical vancomycin application. We observed a significant reduction in SSI among those receiving topical vancomycin compared to those without (0.8% vs 4.9%, p<0.001). The cohorts were similar in demographics and baseline comorbidities, KPS, tumor characteristics, and surgical factors. We identified length-of-stay, previous radiation and preoperative steroid dose as independent risk factors for SSI. Thus, our study identifies potential modifiable risk factors for the prevention of SSI in patient undergoing craniotomy for primary CNS tumors.
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