Ventriculitis asociada a drenaje extraventricular: etiología, diagnóstico y tratamiento enfocado a unidades de cuidados neurocríticos

Ulloque-Caamaño, Liezel; Mo-Carrascal, Joulen; Maraby, Johana; Narvaez‐Rojas, Alexis Rafael; Quintana-Pájaro, Loraine; Ramos-Villegas, Yancarlos; Moscote-Salazar, Luis Rafael

doi:10.24875/ciru.18000052

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…EVD-associated CNSIs are prone to more complicated infections as well as other complications, which may have contributed to this result. 20 …”

Section: Discussionmentioning

confidence: 99%

“…CNSIs are prone to more complicated infections as well as other complications, which may have contributed to this result. 20 FUCC positivity is defined as Persistent Gram-negative bacterial meningitis/encephalitis in this study. The Cox proportional hazard analysis using propensity score weighting revealed that FUCC positivity was not a predictor of mortality, which may be due to the insufficient sample size.…”

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confidence: 99%

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Effect of Follow-Up Cerebrospinal Fluid Cultures in Post-Neurosurgical Patients’ Outcome with Gram-Negative Bacterial Meningitis/Encephalitis

Sun,

Shi,

Ding

et al. 2023

IDR

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Background To investigate the factors associated with follow-up CSF cultures (FUCCs) in post-neurosurgical patients with gram-negative bacterial meningitis/encephalitis and the effect of FUCCs on treatment management and patient outcomes. Methods This single-centered retrospective cohort study enrolled post-neurosurgical patients with gram-negative bacterial meningitis/encephalitis at a tertiary-care university hospital between 2012 and 2022. The risk factors for 28-day mortality were evaluated using multivariate Cox analysis. FUCC-related risk factors were also analyzed. Results Among the 844 enrolled patients, 504 (59.7%) underwent FUCC, and FUCC was found to be associated with lower rates of both all-cause (hazard ratio (HR) 0.391; 95% confidence interval (CI), 0.235–0.651; p<0.001) and attributable mortality (HR 0.463; 95% CI, 0.239–0.897; p=0.023) in Post-neurosurgical patients diagnosed with Gram-negative bacterial meningitis/encephalitis. Moreover, the results of the study underscored that patients with persistent gram-negative bacterial meningitis/encephalitis had a lower all-cause/attributable short-term survival rate according to 28-day mortality Kaplan–Meier analysis (P=0.001/0.006). Conclusion Performing FUCC has been demonstrated to lower mortality rates in Post-neurosurgical patients suffering from Gram-negative bacterial meningitis/encephalitis. The higher mortality rate observed in patients with persistent gram-negative bacterial meningitis/encephalitis suggests that performing FUCC is a crucial component of proper patient care and management, and is therefore recommended for use by clinicians as a standard practice. This finding underscores the significance of consistent implementation of FUCC in the management and prognosis of patients with Post-neurosurgical infections.

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“…EVD-associated CNSIs are prone to more complicated infections as well as other complications, which may have contributed to this result. 20 …”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Effect of Follow-Up Cerebrospinal Fluid Cultures in Post-Neurosurgical Patients’ Outcome with Gram-Negative Bacterial Meningitis/Encephalitis

Sun,

Shi,

Ding

et al. 2023

IDR

View full text Add to dashboard Cite

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“…The incidence of EVD-related infection after neurosurgery ranges from 8% to 22%. Therefore, attention should be given to the clinical application of drainage tubes, and the removal indication should be evaluated as early as possible [ [37] , [38] , [39] , [40] ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors and cerebrospinal fluid indexes analysis of intracranial infection by Acinetobacter baumannii after neurosurgery

Wang

Song

et al. 2023

Heliyon

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Ventriculitis due to multidrug-resistant gram-negative bacilli associated with external ventricular drain: evolution, treatment, and outcomes

Corona-Nakamura,

Arias-Merino,

Ávila-Esparza

et al. 2024

Front. Neurol.

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IntroductionNosocomial infectious ventriculitis caused by multidrug-resistant (MDR) Gram-negative bacilli associated with external ventricular drainage (EVD) placement poses a significant mortality burden and hospital costs.ObjectivesThis study aims to analyze the characteristics, ventriculitis evolution, treatment, and outcomes of patients with ventriculitis due to MDR Gram-negative bacilli associated with EVD placement.MethodsA retrospective cohort study focusing on patients with nosocomial infection caused by MDR Gram-negative bacilli while on EVD was conducted from 2019 to 2022. Medical, laboratory, and microbiological records were collected. The antibiotic resistance of the Gram-negative bacilli isolated in the cerebrospinal fluid (CSF) of patients was analyzed. The risk factors were identified using univariate risk models and were analyzed using survival curves (Cox regression). An adjusted Cox proportional hazards model was also constructed.ResultsAmong 530 patients with suspected EVD-associated ventriculitis, 64 patients with isolation of Gram-negative bacilli in CSF were included. The estimated mortality was 78.12%. Hemorrhages (intracranial, subarachnoid, and intraventricular) were observed in 69.8% of patients. Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa were the most frequently isolated bacilli. In the univariate analysis, significant risk factors for mortality included arterial hypertension, a Glasgow Coma Scale (GCS) score of ≤ 8, invasive mechanical ventilation (IMV) upon hospital admission and during hospitalization, septic shock, and ineffective treatment. The adjusted Cox proportional hazards model revealed that septic shock (HR = 3.3, 95% CI = 1.5–7.2; p = 0.003) and ineffective treatment (HR = 3.2, 1.6–6.5, 0.001) were significant predictors. A high resistance to carbapenems was found for A. baumannii (91.3%) and P. aeruginosa (80.0%). Low resistance to colistin was found for A. baumannii (4.8%) and P. aeruginosa (12.5%).ConclusionIneffective treatment was an independent hazard factor for death in patients with ventriculitis caused by MDR Gram-negative bacilli associated with EVD.

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Ventriculitis asociada a drenaje extraventricular: etiología, diagnóstico y tratamiento enfocado a unidades de cuidados neurocríticos

Cited by 4 publications

References 10 publications

Effect of Follow-Up Cerebrospinal Fluid Cultures in Post-Neurosurgical Patients’ Outcome with Gram-Negative Bacterial Meningitis/Encephalitis

Effect of Follow-Up Cerebrospinal Fluid Cultures in Post-Neurosurgical Patients’ Outcome with Gram-Negative Bacterial Meningitis/Encephalitis

Risk factors and cerebrospinal fluid indexes analysis of intracranial infection by Acinetobacter baumannii after neurosurgery

Ventriculitis due to multidrug-resistant gram-negative bacilli associated with external ventricular drain: evolution, treatment, and outcomes

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