Background and Goal of Study: The overall incidence of surgical infection in patients undergoing craniotomy is around 5%. Infection rate in our hospital was much higher (14% in 2007 and 12.5% in 2008), for this reason a multidisciplinary working group was created.
Materials and methods: The aim of this study was to determine the incidence of nosocomial infection in elective craniotomies (January/2007-December/2015) and to analyze the effectiveness of our therapeutic measures introduced in order to reduce the number of surgical wound infections. 
Results and discussion: The incidence of wound infection was highly variable: 2009 (5.9%), 2010 (16.7%), 2011 (7.4%), 2012 (9.4%), 2013 (8.7%), 2014 (3.5%). A total of 221 procedures were analyzed between 2012 and 2013. We found a total of 20 postoperative wound infections. We obtained 15 bacterial isolations: S. Aureus (4), S. Epidermidis (1), S. Pyogenes (1), S. Agalactiae (1), Acinetobacter Baumannii (1), Klebsiella Pneumoniae BLEE (2), Klebsiella (1), Bacteroides (1), Enterobacter Cloacae (2), E.Coli (1).These findings showed that 53 % of the isolated pathogens were gram-negative bacteria that were not covered with the empirical antibiotic prophylaxis made with cefazolin and in 2014th was replaced for cefuroxime. After these changes the rate infection along 2014 was 3.5%, 4 of the 114 craniotomies were infected and 2 cocoas gram-positive were identified. 
Conclusion(s): Knowledge of the local microbiology of infections is essential to guide both prophylaxis and empirical antibiotic therapy. The multidisciplinary approach of the surgical wound infections helps to enhance the results.

Incidence of surgical wound infections in patients undergoing craniotomy during the period 2007-2014