Hospital-Acquired Infections after Aneurysmal Subarachnoid Hemorrhage: A Nationwide Analysis

Dasenbrock, Hormuzdiyar H.; Rudy, Robert F.; Smith, Timothy R.; Guttieres, Donovan; Frerichs, Kai U.; Gormley, William B.; Aziz-Sultan, Mohammad Ali; Du, Rose

doi:10.1016/j.wneu.2015.10.054

Cited by 57 publications

(55 citation statements)

References 65 publications

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“…Patients who were treated for a (suspected) bacterial ventriculitis were more often in a worse clinical condition, hence the expectation to be ventilator-dependent. These poor condition patients are also the patients who are more prone to develop a bacterial ventriculitis [2]. Prophylactic antibiotics may mask a positive CSF culture leading to a negative CSF culture in patients with true bacterial ventriculitis.…”

Section: Discussionmentioning

confidence: 99%

“…Infections in patients with a subarachnoid hemorrhage (SAH), mainly pneumonia, urinary tract infections, blood stream infections, or bacterial ventriculitis, are independently associated with a prolonged stay in the intensive care unit (ICU), a poor outcome and increased mortality [1, 2]. Bacterial ventriculitis is reported in 3–29 % of SAH patients [2–6] and is strongly associated with the placement of CSF (cerebrospinal fluid) catheters [5, 7].…”

Section: Introductionmentioning

confidence: 99%

“…Bacterial ventriculitis is reported in 3–29 % of SAH patients [2–6] and is strongly associated with the placement of CSF (cerebrospinal fluid) catheters [5, 7]. Although infections and fever after SAH have been studied, which includes ventriculitis, no specific study has paid attention specifically and solely to suspected bacterial ventriculitis in this subgroup [1, 3–6, 8].…”

Section: Introductionmentioning

confidence: 99%

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Clinical and Laboratory Characteristics for the Diagnosis of Bacterial Ventriculitis After Aneurysmal Subarachnoid Hemorrhage

et al. 2016

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BackgroundThe diagnosis of nosocomial bacterial ventriculitis in patients with subarachnoid hemorrhage (SAH) can be challenging.Methods We performed a retrospective study on the diagnostic accuracy of clinical and laboratory characteristics for the diagnosis of bacterial ventriculitis in 209 consecutive patients with an aneurysmal SAH admitted in a tertiary referral center from 2008 to 2010. Diagnostic value of clinical characteristics and inflammatory indexes in CSF and blood were determined for three diagnostic categories: (1) no suspicion for bacterial ventriculitis; (2) clinical suspicion for bacterial ventriculitis, defined as initiation of empirical antibiotic treatment for ventriculitis, but negative CSF cultures; and (3) CSF culture-positive bacterial ventriculitis. ResultsEmpirical antibiotics for suspected ventriculitis was initiated in 48 of 209 (23 %) patients. CSF cultures were positive in 11 (5 %) patients. Within the group of suspected ventriculitis, only longer duration of CSF drainage and lower CSF red blood cell counts predicted for culture positivity. None of the other clinical features or inflammatory indexes in CSF and blood were associated with culture-proven bacterial ventriculitis.ConclusionsNosocomial bacterial ventriculitis in patients with aneurysmal SAH is often suspected but confirmed by culture in a minority of cases. Improvement of diagnostics for nosocomial bacterial ventriculitis in patients with aneurysmal SAH is needed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical and Laboratory Characteristics for the Diagnosis of Bacterial Ventriculitis After Aneurysmal Subarachnoid Hemorrhage

et al. 2016

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“…Aneurysmal subarachnoid hemorrhage (SAH) is associated with a mortality rate of around 40-50% [1,2]. Despite successful aneurysm obliteration from the systemic circulation, a very high proportion of SAH patients confront life-threatening complications, and more than one-third of SAH patients develop systemic or local infections [3][4][5][6][7][8][9]. Post-SAH immunodepression may influence occurrence of infections.…”

Section: Introductionmentioning

confidence: 99%

Elevated Systemic IL-10 Levels Indicate Immunodepression Leading to Nosocomial Infections after Aneurysmal Subarachnoid Hemorrhage (SAH) in Patients

Chaudhry

Kahlert

Kinfe

et al. 2020

IJMS

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Background: Aneurysmal subarachnoid hemorrhage (SAH) is a highly complex disease with very high mortality and morbidity. About one-third of SAH patients suffer from systemic infections, predominantly pneumonia, that can contribute to excess mortality after SAH. Immunodepression is probably the most important mechanism leading to infections. Interleukin-10 (IL-10) is a master regulator of immunodepression, but it is still not clear if systemic IL-10 levels contribute to immunodepression, occurrence of infections and clinical outcome after SAH. Methods: This explorative study included 76 patients with SAH admitted to our neurointensive care unit within 24 h after ictus. A group of 24 patients without any known intracranial pathology were included as controls. Peripheral venous blood was withdrawn on day 1 and day 7 after SAH. Serum was isolated by centrifugation and stored at −80 °C until analysis. Serum IL-10 levels were determined by enzyme-linked immunoassay (ELISA). Patient characteristics, post-SAH complications and clinical outcome at discharge were retrieved from patients’ record files. Results: Serum IL-10 levels were significantly higher on day 1 and day 7 in SAH patients compared to controls. Serum IL-10 levels were significantly higher on day 7 in patients who developed any kind of infection, cerebral vasospasm (CVS) or chronic hydrocephalus. Serum IL-10 levels were significantly higher in SAH patients discharged with poor clinical outcome (modified Rankin Scale (mRS) 3–6 or Glasgow Outcome Scale (GOS) 1–3). Conclusion: Serum IL-10 might be an additional useful parameter along with other biomarkers to predict post-SAH infections.

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“…For CCM patients, there are several possible causes of postoperative infection-related complications and predicting such complications remains a challenge. Studies investigating the benefits of assessing clinical scores, [eg, Glasgow Coma Scale (GCS), Karnofsky Performance Scale (KPS) and Modified Rankin Scale (mRS)] and monitoring inflammation [eg, white blood cell (WBC) count and C-reactive protein level] to help in the prediction of postoperative infection-related complications have provided ambiguous results for many other types of cerebrovascular diseases, including aneurysmal subarachnoid hemorrhage and stroke [9][10][11][12][13] . Therefore, in this study, we sought to investigate the predictive factors of postoperative infection-related complications in patients with CCM.…”

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confidence: 99%

Predictive factors of postoperative infection-related complications in adult patients with cerebral cavernous malformations

Ding

Lian

et al. 2020

Sci Rep

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Materials and Methods Study population. Information of CCM patients admitted between January 2010 and December 2017 to the Department of Neurosurgery of the First Affiliated Hospital of Fujian Medical University was retrospectively reviewed. A total of 167 patients were included, the average age of patients was 39.69 ± 15.27 years, with 43.1% (72/167) being female. The inclusion criteria were: (1) Age >18 years old; (2) diagnosed with CCM based on preoperative imaging, treated with surgery and confirmed with CCM based on postoperative pathological result. Exclusion criteria were: (1) Patient with incomplete disease information, such as missing any of the following: assessment of disease severity (including GCS, KPS and mRS) and WBC differential count (including the WBC count, neutrophil (NEU) count and lymphocyte (LYM) count) at admission, imaging and pathological information, and information on postoperative complications; (2) the patient had any type of surgery or acute or chronic infection within the past month; (3) prior onset of other neurological diseases such as intracranial tumors, stroke or severe head trauma; (4) patient had previous CCM surgery; (5) previous use of immunosuppressants; (6) other systemic diseases, such as autoimmune disease, uremia, cirrhosis, cancer, and chronic lung and heart diseases. The study conformed to the ethical guidelines of the Declaration of Helsinki. The local Ethics Committee of the First Affiliated Hospital of Fujian Medical University (Fujian, China) approved this study and waived the requirement for informed consent because of its retrospective design.

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Hospital-Acquired Infections after Aneurysmal Subarachnoid Hemorrhage: A Nationwide Analysis

Cited by 57 publications

References 65 publications

Clinical and Laboratory Characteristics for the Diagnosis of Bacterial Ventriculitis After Aneurysmal Subarachnoid Hemorrhage

Clinical and Laboratory Characteristics for the Diagnosis of Bacterial Ventriculitis After Aneurysmal Subarachnoid Hemorrhage

Elevated Systemic IL-10 Levels Indicate Immunodepression Leading to Nosocomial Infections after Aneurysmal Subarachnoid Hemorrhage (SAH) in Patients

Predictive factors of postoperative infection-related complications in adult patients with cerebral cavernous malformations

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