TABLE 3.
Outcomes of Studies Relating to Electrode Externalization and Infection
| Author, year | No. of patients with infection | Infection rate | Indication (no. of patients) | Average time to infection (months) | Microbiology of infection (no. of infections) | Site of infection (no. of infections) | Management (no. of infections) | Increased risk? (P value) |
|---|---|---|---|---|---|---|---|---|
| Franco, 201834 | 2 | 50.0 | PWS (2) | 4 | INS | C (1), IPG (1) | A (1), RH (1) | NA |
| Boccard, 201739 | 5 | 20.8 | Pain (5) | INS | INS | INS | RH (6) | NA |
| Rosa, 201722 | 3 | 2.9 | PD (3) | 6 | Staphylococcus aureus (2), Nocardia farcinica (1) | IPG (3) | A, RH (3) | No (.054)a |
| Lee, 201427 | 0 | 0 | NA | NA | NA | NA | NA | NA |
| Pepper, 201333 | 4 | 4.0 | PD (3) tremor (1) | 2.1 | Gram negative rod (1), Klebsiella pneumoniae (1), coagulase-negative Staphylococcus, Enterobacter intermedius, and Candida famata (1) | IPG (1), IPG and BH (1), BH (2) | RH (4) | No (.78) |
| Schlaepfer, 201335 | 2 | 28.6 | MDD (1) | INS | INS | IPG (2) | INS | INS |
| Ackermans, 201126 | 1 | 16.7 | TS (1) | INS | S. aureus (1) | IPG (1) | A (1) | NA |
| Vergani, 201040 | 8 | 5.7 | PD (8) | INS | S. aureus (2), Pseudomonas (2), S. epidermidis (2) | Intracranial lead (2), IPG (6) | RH (3); A (3); A, RH (2) | NA |
| Mehrkens, 200941 | 1 | 8.3 | Dystonia (1) | 0.5 | INS | BH (1) | RH (1) | NA |
| Owen, 200742 | 2 | 6.3 | Pain (2) | INS | INS | INS | A (2) | NA |
| Hamani, 200643 | 1 | 4.8 | Pain (1) | INS | INS | INS | RH (2) | NA |
| Constantoyannis, 200538 | 4 | 15.3 | INS | INS | INS | INS | A/RH (INS) | Yes (.003) |
| Green, 200544 | 1 | 14.3 | Pain (1) | INS | INS | INS | A, RH (1) | NA |
| Bojanic, 200428 | 3 | 3.5 | Pain (3) | INS | N/A | IPG (3) | INS | No (<.099) |
| Temel, 200411 | 4 | 3.8 | PD (4) | 1.9 | S. aureus (4) | IPG (2), IPG and C (1), C (1) | A (2); A, D, RH (2) | NA |
| Oh, 200245 | 10 | 12.7 | Dystonia (2); pain (2); PD (5); tremor (1) | 10.2 | S. aureus (2), Mycobacterium fortuitum (1), Enterobacter (1), Pseudomonas (1) | BH (3), BH and C (1), IPG (1), C (5) | A, D (1); A, D, RH (5); RH (4) | NA |
| Vesper, 200246 | 2 | 5.3 | PD (2) | INS | INS | IPG (2) | RH (2) | NA |
| Vercueil, 200136 | 1 | 5.3 | Dystonia (1) | INS | INS | BH (1) | RH (1) | NA |
| Kumar, 199729 | 4 | 5.9 | Pain (4) | INS | INS | INS | A (3); RH (1) | NA |
| Benabid, 199637 | 3 | 2.6 | INS | INS | INS | C (3) | RH (3) | NA |
| Levy, 198730 | 17 | 12.1 | Pain (17) | INS | S. epidermidis (9), S. aureus (6), Propionibacterium acnes (2), Group B Streptococcus (1), Micrococcus (1), Enterobacter cloacae (1) | BH (19), IPG (3), C (1) | A (4); A, D (8); A, RH (11) | NA |
| Dieckmann, 198231 | 2 | 4.3 | Pain (2) | INS | INS | INS | INS | NA |
| Plotkin, 198232 | 2 | 3.3 | Pain (2) | 7.5 | INS | C (1) Scalp, not specified (1) | A (1); A, RH (1) | NA |
A, antibiotics; BH, on scalp overlying burr hole; C, on scalp overlying connecting cable; D, debridement; INS, information not supplied; IPG, internal pulse generator; MDD, major depressive disorder; NA, not applicable; No., number; PD, Parkinson's disease; PWS, Prader-Willi syndrome; RH, removal of hardware; TS, Tourette syndrome.
a
Although this study did not include a control group, they performed a comparison of the incidence of infection in their cohort with rates of infection previously reported in the literature.