Retrospective Analysis of Ventriculitis in External Ventricular Drains
Background. Nosocomial EVD-related ventriculitis is a major complication and a significant cause of morbidity and mortality in critically ill neurological patients. Questions remain about best management of EVDs. The purpose of this study is to compare our incidence of ventriculitis to studies using...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Neurology Research International |
| Online Access: | http://dx.doi.org/10.1155/2018/5179356 |
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| author | Stephen Albano Blake Berman Glenn Fischberg Javed Siddiqi Bolin Liu Yasir Khan Atif Zafar Syed A. Quadri Mudassir Farooqui |
| author_facet | Stephen Albano Blake Berman Glenn Fischberg Javed Siddiqi Bolin Liu Yasir Khan Atif Zafar Syed A. Quadri Mudassir Farooqui |
| author_sort | Stephen Albano |
| collection | DOAJ |
| description | Background. Nosocomial EVD-related ventriculitis is a major complication and a significant cause of morbidity and mortality in critically ill neurological patients. Questions remain about best management of EVDs. The purpose of this study is to compare our incidence of ventriculitis to studies using different catheters and/or antibiotic coverage schemes and determine whether c-EVD with prolonged antibiotics given for the duration of drain placement is inferior to ac-EVD with pp-abx or ac-EVD with prolonged antibiotics for prevention of ventriculitis. Methods. A retrospective chart review of all patients who had EVDs placed from January 2010 through December 2015 at home institution was performed. Statistical analysis was performed using Fisher’s exact test to compare incidence of ventriculitis identified in other studies with that of home institution. Results. The study included 107 patients, 66 (61.7%) males and 41 (38.3%) females. Average age was 56 years ranging from 18 to 95 years. Average length of drain placement was 7.8 days ranging from 2 to 23 days. Average length of drain placement in infected drains was 13.3 days ranging from 11 to 15 days. There were 3 cases with positive CSF cultures (Staphylococcus haemolyticus and Staphylococcus epidermidis x 2). There were 2 cases with a CSF having a positive gram stain but failed to yield any bacterial growth on culture and did not meet predefined criteria. Conclusions. The c-EVD with prolonged antibiotics given for the duration of drain placement is not inferior to ac-EVD with pp-abx or ac-EVD with prolonged antibiotics for prevention of ventriculitis. The c-EVD with prolonged antibiotics is superior to c-EVD with pp-abx and conventional EVD without antibiotics for prevention of ventriculitis. Selection should include considerations for antibiotic stewardship and cost effectiveness. Future studies should also utilize clinical and CSF profile criteria in addition to positive CSF cultures for identifying ventriculitis to prevent line colonization from classification as ventriculitis in analysis. |
| format | Article |
| id | doaj-art-f53b50879fd1471b89f10b967370cd87 |
| institution | Kabale University |
| issn | 2090-1852 2090-1860 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Neurology Research International |
| spelling | doaj-art-f53b50879fd1471b89f10b967370cd872025-02-03T05:50:34ZengWileyNeurology Research International2090-18522090-18602018-01-01201810.1155/2018/51793565179356Retrospective Analysis of Ventriculitis in External Ventricular DrainsStephen Albano0Blake Berman1Glenn Fischberg2Javed Siddiqi3Bolin Liu4Yasir Khan5Atif Zafar6Syed A. Quadri7Mudassir Farooqui8Desert Regional Medical Center, Palm Springs, CA, USADesert Regional Medical Center, Palm Springs, CA, USADesert Regional Medical Center, Palm Springs, CA, USADesert Regional Medical Center, Palm Springs, CA, USADesert Regional Medical Center, Palm Springs, CA, USADesert Regional Medical Center, Palm Springs, CA, USAUniversity of New Mexico, NM, USADesert Regional Medical Center, Palm Springs, CA, USAUniversity of New Mexico, NM, USABackground. Nosocomial EVD-related ventriculitis is a major complication and a significant cause of morbidity and mortality in critically ill neurological patients. Questions remain about best management of EVDs. The purpose of this study is to compare our incidence of ventriculitis to studies using different catheters and/or antibiotic coverage schemes and determine whether c-EVD with prolonged antibiotics given for the duration of drain placement is inferior to ac-EVD with pp-abx or ac-EVD with prolonged antibiotics for prevention of ventriculitis. Methods. A retrospective chart review of all patients who had EVDs placed from January 2010 through December 2015 at home institution was performed. Statistical analysis was performed using Fisher’s exact test to compare incidence of ventriculitis identified in other studies with that of home institution. Results. The study included 107 patients, 66 (61.7%) males and 41 (38.3%) females. Average age was 56 years ranging from 18 to 95 years. Average length of drain placement was 7.8 days ranging from 2 to 23 days. Average length of drain placement in infected drains was 13.3 days ranging from 11 to 15 days. There were 3 cases with positive CSF cultures (Staphylococcus haemolyticus and Staphylococcus epidermidis x 2). There were 2 cases with a CSF having a positive gram stain but failed to yield any bacterial growth on culture and did not meet predefined criteria. Conclusions. The c-EVD with prolonged antibiotics given for the duration of drain placement is not inferior to ac-EVD with pp-abx or ac-EVD with prolonged antibiotics for prevention of ventriculitis. The c-EVD with prolonged antibiotics is superior to c-EVD with pp-abx and conventional EVD without antibiotics for prevention of ventriculitis. Selection should include considerations for antibiotic stewardship and cost effectiveness. Future studies should also utilize clinical and CSF profile criteria in addition to positive CSF cultures for identifying ventriculitis to prevent line colonization from classification as ventriculitis in analysis.http://dx.doi.org/10.1155/2018/5179356 |
| spellingShingle | Stephen Albano Blake Berman Glenn Fischberg Javed Siddiqi Bolin Liu Yasir Khan Atif Zafar Syed A. Quadri Mudassir Farooqui Retrospective Analysis of Ventriculitis in External Ventricular Drains Neurology Research International |
| title | Retrospective Analysis of Ventriculitis in External Ventricular Drains |
| title_full | Retrospective Analysis of Ventriculitis in External Ventricular Drains |
| title_fullStr | Retrospective Analysis of Ventriculitis in External Ventricular Drains |
| title_full_unstemmed | Retrospective Analysis of Ventriculitis in External Ventricular Drains |
| title_short | Retrospective Analysis of Ventriculitis in External Ventricular Drains |
| title_sort | retrospective analysis of ventriculitis in external ventricular drains |
| url | http://dx.doi.org/10.1155/2018/5179356 |
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