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Soto Hernández JL, González LER, Ramírez GR, Hernández CH, Torreblanca NR, Morales VÁ, Moreno KF, Peek MR, Jiménez SM. The Impact of the COVID-19 Pandemic in Postoperative Neurosurgical Infections at a Reference Center in México. Antibiotics (Basel) 2023; 12:1055. [PMID: 37370372 DOI: 10.3390/antibiotics12061055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
The COVID-19 pandemic has had a major global impact on the treatment of hospitalized surgical patients. Our study retrospectively evaluates the impact of the COVID-19 pandemic at a neurosurgical reference center in Mexico City. We compared the number of neurosurgeries, the rate and type of postoperative infections, the causative microorganisms and in-hospital mortality rates in a 4-year period, from the pre-pandemic year 2019 until 2022. A total of 4150 neurosurgical procedures were registered. In 2020 the total number of surgeries was reduced by 36% compared to 2019 OR = 0.689 (95% CI 0.566-0.834) p ≤ 0.001, transnasal/trans sphenoidal pituitary resections decreased by 53%, and spinal surgeries by 52%. The rate of neurosurgical infections increased from 3.5% in 2019 to 5.6% in 2020 (p = 0.002). Regarding the microorganisms that caused infections, gram positive cocci accounted for 43.5% of isolates, Klebsiella spp. and Pseudomonas spp. caused one third of the infections. No significant differences were found for in-hospital mortality nor patterns of resistance to antibiotics. The number of surgeries increased in the last two years, although the infection rate has returned to pre-pandemic levels. We observed a lower impact from subsequent waves of COVID-19 and despite an increase in the number of surgeries, the surgeries have not amounted to the full pre-pandemic levels.
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Affiliation(s)
- José Luis Soto Hernández
- Infectious Diseases Department, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Tlalpan, Ciudad de México 14269, Mexico
| | - Luis Esteban Ramírez González
- Infectious Diseases Department, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Tlalpan, Ciudad de México 14269, Mexico
| | - Guadalupe Reyes Ramírez
- Infection Control Committee, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Tlalpan, Ciudad de México 14269, Mexico
| | - Carolina Hernández Hernández
- Infection Control Committee, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Tlalpan, Ciudad de México 14269, Mexico
| | - Natalia Rangel Torreblanca
- Infection Control Committee, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Tlalpan, Ciudad de México 14269, Mexico
| | - Verónica Ángeles Morales
- Microbiology Laboratory, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Tlalpan, Ciudad de México 14269, Mexico
| | - Karen Flores Moreno
- Microbiology Laboratory, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Tlalpan, Ciudad de México 14269, Mexico
| | - Miguel Ramos Peek
- Neurosurgery Division, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Tlalpan, Ciudad de México 14269, Mexico
| | - Sergio Moreno Jiménez
- Neurosurgery Division, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Tlalpan, Ciudad de México 14269, Mexico
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