Bacterial meningitis caused by the use of ventricular or lumbar cerebrospinal fluid catheters.

OBJECT In the present study the authors compared the incidence and risk factors for external drainage-related bacterial meningitis (ED-BM) by using ventricular and lumbar catheters. METHODS A cohort of 230 consecutive patients with ED was evaluated. Cerebrospinal fluid samples were obtained daily for microbiological culture, and ED-BM was defined based on culture results in combination with clinical symptoms. The incidence of ED-BM was 7% in lumbar and 15% in ventricular drains. Independent risk factors included site leakage, drain blockage, and most importantly duration of ED. Despite a higher infection rate, ventricular catheters did not have a significant higher risk of infection after correcting for duration of drainage. CONCLUSIONS Analysis of data in the present study showed that the incidence of ED-associated death is low (0.45%) in patients who do not receive continuous antibiotic prophylaxis during ED.

[1]  D. John Doyle,et al.  Analysis of intracranial pressure , 2005, Journal of Clinical Monitoring.

[2]  P. Gerner-Smidt,et al.  Ventriculostomy-related infections—an epidemiological study , 2005, Acta Neurochirurgica.

[3]  H. Seifert,et al.  Clinical management of catheter-related infections. , 2002, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[4]  E. Connolly,et al.  Ventriculostomy-related Infections: A Critical Review of the Literature , 2002, Neurosurgery.

[5]  R. Tuncer,et al.  Complications of Closed Continuous Lumbar Drainage of Cerebrospinal Fluid , 2002, Acta Neurochirurgica.

[6]  K. Polderman,et al.  Central venous catheter use. Part 2: infectious complications. , 2002, Intensive care medicine.

[7]  M. Williams,et al.  Ventriculitis complicating use of intraventricular catheters in adult neurosurgical patients. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[8]  W. Coplin,et al.  Infection related to intracranial pressure monitors in adults: analysis of risk factors and antibiotic prophylaxis , 2000, Journal of neurology, neurosurgery, and psychiatry.

[9]  J. Zabramski,et al.  The Efficacy and Cost of Prophylactic and Periprocedural Antibiotics in Patients with External Ventricular Drains , 1999, Neurosurgery.

[10]  E. Brown,et al.  The management of neurosurgical patients with postoperative bacterial or aseptic meningitis or external ventricular drain-associated ventriculitis , 2000 .

[11]  H. Winn,et al.  Bacterial meningitis associated with lumbar drains: a retrospective cohort study , 1999, Journal of neurology, neurosurgery, and psychiatry.

[12]  S. Chibbaro,et al.  Infections and re-infections in long-term external ventricular drainage. A variation upon a theme. , 1999, Journal of neurosurgical sciences.

[13]  W. Poon,et al.  CSF antibiotic prophylaxis for neurosurgical patients with ventriculostomy: a randomised study. , 1998, Acta neurochirurgica. Supplement.

[14]  K. Holloway,et al.  Ventriculostomy infections: the effect of monitoring duration and catheter exchange in 584 patients. , 1996, Journal of neurosurgery.

[15]  M. K. Bader,et al.  Ventriculostomy and intracranial pressure monitoring: in search of a 0% infection rate. , 1995, Heart & lung : the journal of critical care.

[16]  P. Rosenthal,et al.  Duration of intracranial pressure monitoring does not predict daily risk of infectious complications. , 1993, Neurosurgery.

[17]  K. Moore,et al.  Bacterial Ventriculitis and Duration of Ventriculostomy Catheter Insertion , 1993, The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses.

[18]  U. Bogdahn,et al.  Continuous-pressure controlled, external ventricular drainage for treatment of acute hydrocephalus--evaluation of risk factors. , 1992, Neurosurgery.

[19]  S. Shapiro,et al.  Closed continuous drainage of cerebrospinal fluid via a lumbar subarachnoid catheter for treatment or prevention of cranial/spinal cerebrospinal fluid fistula. , 1992, Neurosurgery.

[20]  B. A. Green,et al.  Closed subarachnoid drainage for management of cerebrospinal fluid leakage after an operation on the spine. , 1989, The Journal of bone and joint surgery. American volume.

[21]  C. Nordström,et al.  Complications due to prolonged ventricular fluid pressure recording. , 1988, British journal of neurosurgery.

[22]  Eric Simrod.  Intracranial pressure monitors. Epidemiologic study of risk factors and infections:Aucoin PJ, Kotilainen HR, Gantz NM, et al Am J Med 80:369–376 Mar 1986 , 1986 .

[23]  N. Gantz,et al.  Intracranial pressure monitors. Epidemiologic study of risk factors and infections. , 1986, The American journal of medicine.

[24]  R. Narayan,et al.  Ventriculostomy-Related Infections , 1984 .

[25]  R. Narayan,et al.  Ventriculostomy-Related Infections , 1984 .

[26]  H. Portnoy,et al.  Systems analysis of intracranial pressure. Comparison with volume-pressure test and CSF-pulse amplitude analysis. , 1980, Journal of neurosurgery.

[27]  Ellen Jo Baron,et al.  Manual of clinical microbiology , 1975 .