Integrated infection surveillance in neurosurgery to inform patient management.

We congratulate Iro et al. on their publication describing the recent increase in central nervous system abscesses and associated case-fatality in England over the last two decades. 1 Iro M.A. Goldacre M.J. Goldacre R. Central nervous system abscesses and empyemas in England: epidemiological trends over five decades. J Infect. 2023; 86: 309-315 Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar The dataset spanned 50 years and included intracranial, sub/extra dural and spinal abscesses. A paucity of published data and research exists in this area, 2 Sonneville R. Ruimy R. Benzonana N. Riffaud L. Carsin A. Tadié J.M. et al. An update on bacterial brain abscess in immunocompetent patients. Clin Microbiol Infect Publ Eur Soc Clin Microbiol Infect Dis. 2017; 23: 614-620 Abstract Full Text Full Text PDF PubMed Scopus (85) Google Scholar especially at population-level and over a long time-span. The authors describe presentations predominantly in males and in infants /older adults with low mortality rates which increased with age. Likewise, we previously reported a predominance of male patients presenting with frontal lobe brain abscess in our hospital from 1988 to 2000. 3 Roche M. Humphreys H. Smyth E. Phillips J. Cunney R. McNamara E. et al. A twelve-year review of central nervous system bacterial abscesses; presentation and aetiology. Clin Microbiol Infect Publ Eur Soc Clin Microbiol Infect Dis. 2003; 9: 803-809 Abstract Full Text Full Text PDF PubMed Scopus (109) Google Scholar In-hospital mortality at that time was 9.8%, viridans streptococci were most commonly cultured and a concerning increase in meticillin-resistant Staphylococcus aureus (MRSA) infections reported.