Surveillance and management of ventriculitis following neurosurgery

Humphreys, Hilary; Jenks, Peter J.

doi:10.1016/j.jhin.2014.12.019

Cited by 46 publications

(33 citation statements)

References 31 publications

(38 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Antibiotic and silver-impregnated CSF shunts and EVDs have been developed to reduce microbial colonization of these devices, which have cut the rates of infection by half in some studies (4,19,20). Synthetic implants have also been developed to replace the bone during cranioplasty procedures, but there is no convincing data to suggest that these are superior to the autologous bone graft material (9).…”

Section: Pathophysiology Of Infectionmentioning

confidence: 99%

Diagnostic Approach to Health Care- and Device-Associated Central Nervous System Infections

et al. 2018

View full text Add to dashboard Cite

Health care- and device-associated central nervous system (CNS) infections have a distinct epidemiology, pathophysiology, and microbiology that require a unique diagnostic approach. Most clinical signs, symptoms, and tests used to diagnose community-acquired CNS infections are insensitive and nonspecific in neurosurgical patients due to postsurgical changes, invasive devices, prior antimicrobial exposure, and underlying CNS disease. The lack of a standardized definition of infection or diagnostic pathway has added to this challenge. In this review, we summarize the epidemiology, microbiology, and clinical presentation of these infections, discuss the issues with existing microbiologic tests, and give an overview of the current diagnostic approach.

show abstract

Section: Pathophysiology Of Infectionmentioning

confidence: 99%

Diagnostic Approach to Health Care- and Device-Associated Central Nervous System Infections

et al. 2018

View full text Add to dashboard Cite

show abstract

“…These studies have shown serious consequences of ventriculitis, which can include impaired intellectual capacity, prolonged hospital stay, as well as death. [11] The overall mortality rate among patients with ventriculitis has been reported to be in the 8–70% range, with the highest rates reported before the introduction of third-generation cephalosporins. [9]…”

Section: Introductionmentioning

confidence: 99%

Will clinical parameters reliably predict external ventricular drain-associated ventriculitis: Is frequent routine cerebrospinal fluid surveillance necessary?

Hariri¹,

Farr²,

Lawandy³

et al. 2017

Surg Neurol Int

View full text Add to dashboard Cite

Background:The placement of an external ventricular drain (EVD) for monitoring and treatment of increased intracranial pressure is not without risk, particularly for the development of associated ventriculitis. The goal of this study was to investigate whether changes in cerebrospinal fluid (CSF), serum, or clinical parameters are correlated with the development of ventriculitis before it occurs, allowing for the determination of optimal timing of CSF collection.Methods:An observational retrospective study was conducted between January 2006 and May 2012. A total of 466 patients were identified as having an in-situ EVD placed. Inclusion criteria were age >18 years, glasgow coma scale (GCS) 4-15, and placement of EVD for any indication. Exclusion criteria included recent history of meningitis, cerebral abscess, cranial surgery or open skull fracture within the previous 30 days. A broad definition of ventriculitis was used to separate patients into three initial categories, two of which had sufficient patients to proceed with analysis: suspected ventriculitis and confirmed ventriculitis. CSF sampling was conducted on alternating weekdays.Results:A total of 466 patients were identified as having an EVD and 123 patients were included in the final analysis. The incidence of ventriculitis was 8.8%. Only the ratio of glucose CSF: serum <0.5 was found to be of statistical significance, though not correlated to developing a ventriculitis.Conclusions:This study demonstrates no reliable tested CSF, serum, or clinical parameters that are effectively correlated with the development of ventriculitis in an EVD patient. Thus, we recommend and will continue to draw CSF samples from patients with in-situ EVDs on our current schedule for as long as the EVD remains in place.

show abstract

“…Several studies have shown that these have the potential to reduce shunt infection and revision rates. [48][49][50] In one study of 100 patients requiring EVDs, antibiotic-impregnated catheters were associated with 2.7 fewer deaths and 82 fewer hospital days due to infection. 51 Another study which obtained data from 288 patients found that rifampicin-and minocycline-impregnated catheters were half as likely as nonimpregnated catheters to be colonized, and more importantly, the authors reported that positive CSF cultures were 7 times less frequent when using antibiotic-impregnated catheters.…”

Section: Prophylaxismentioning

confidence: 99%

Neurosurgical Infections

2019

View full text Add to dashboard Cite

Patients in the neurointensive care unit often undergo life-saving neurosurgical interventions that can be associated with serious complications. Infection is a common and sometimes fatal complication of such procedures. Infection may occur not only in the setting of major cranial and spinal surgery, but also with common minor procedures that utilize neurosurgical devices, such as placement of external ventricular drains, ventriculoperitoneal shunts, and deep brain stimulators. In this article, we review the epidemiology and microbiology of these infections, and discuss their general and procedure-specific risk factors and treatment options.

show abstract

Surveillance and management of ventriculitis following neurosurgery

Cited by 46 publications

References 31 publications

Diagnostic Approach to Health Care- and Device-Associated Central Nervous System Infections

Diagnostic Approach to Health Care- and Device-Associated Central Nervous System Infections

Will clinical parameters reliably predict external ventricular drain-associated ventriculitis: Is frequent routine cerebrospinal fluid surveillance necessary?

Neurosurgical Infections

Contact Info

Product

Resources

About