Comprehensive Review on Postoperative Central Nervous System Infections (PCNSI): Causes, Prevention Strategies, and Therapeutic Approaches using Computer Based Electronic Health Record (EHR)

The central nervous system is susceptible to various infections. Over centuries, bacterial infections have proven lethal in various surgical procedures. Infections that occur after craniotomy are often due to the reopening of operating wounds and past contamination of the scalp. Electronic health record (EHR) although provides programs to support surveillance efforts for these infections. However,the problem with these tools traditionally used is the lack of accuracy. Till now, the EHR systems are giving data to monitor and plan for these infections but this system needs more accuracy. The rate of postoperative infection in craniotomy ranges from 0.8% to 7% in patients who have received preoperative antibiotic prophylaxis. This rate increases significantly to about 10% in patients without antibiotic prophylaxis. Different types of bacteria manifest infections at different intervals after surgery. For instance, Streptococcus pyogenesinfections typically appear within one or two days, Staphylococcal infections usually become evident after four tofive days post-surgery, while gram-negative bacillary problems may arise within six or seven days. Resistance in bacteria contributes to the prevalence of postoperative infections, with examples such as Vancomycin Resistant Streptococcus aureus(VRSA), Vancomycin Resistant Enterococci (VRE), and Methicillin-Resistant Streptococcus aureus(MRSA). Given the high incidence of postoperative neurosurgical infections, there is a pressing need to manage such infections meticulously to reduce the risk of infections and associated fatalities. Treatment options include antibiotics and surgical practices aimed at minimizing pathogenic infections. Early and prompt recognition of bacterial infections after craniotomy is crucial, necessitating an understanding of both local and general infection symptoms. Additionally, cranioplasty can be considered as a means to address postoperative neurosurgical pathogenic infections.