Characteristics of infections associated with external ventricular drains of cerebrospinal fluid.

Détails

ID Serval
serval:BIB_0814E0362C81
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Characteristics of infections associated with external ventricular drains of cerebrospinal fluid.
Périodique
Journal of Infection
Auteur(s)
Walti L.N., Conen A., Coward J., Jost G.F., Trampuz A.
ISSN
1532-2742 (Electronic)
ISSN-L
0163-4453
Statut éditorial
Publié
Date de publication
2013
Volume
66
Numéro
5
Pages
424-431
Langue
anglais
Notes
Publication types: Journal ArticlePublication Status: ppublish
Résumé
OBJECTIVES: Manifestations of external ventricular drain (EVD) - associated infections overlap with those of the underlying neurosurgical conditions. We analyzed characteristics of EVD-associated infections.
METHODS: We included patients aged ≥18 years with EVD-associated infections from 1997 to 2008, using modified CDC criteria for nosocomial infections. Hospital charts were reviewed retrospectively and the in-hospital outcome was evaluated.
RESULTS: Forty-eight patients with EVD-associated infections were included (median age, 52 years, range 20-74 years). The median EVD-indwelling time was 7 days (range, 1-39 days) and EVD-associated infection occurred 6 days after insertion (range, 1-17 days). In 23% of patients, meningitis occurred 1-10 days after EVD removal. Fever >38 °C was present in 79% of patients, but Glasgow Coma Scale (GCS) scores were reduced in only 29%, and headache, vomiting and/or neck stiffness were present in only 31%. The median cerebrospinal fluid (CSF) leukocyte count was higher at onset of EVD-associated infection than at EVD insertion (175 × 10(6)/l versus 46 × 10(6)/l, p = 0.021), but other CSF parameters did not differ significantly. The most commonly implicated organisms were coagulase-negative staphylococci (63%) and Propionibacterium acnes (15%).
CONCLUSIONS: Fever and increased CSF leukocytes should raise the suspicion of EVD-associated infection, which may occur up to 10 days after removal of EVD.
Pubmed
Web of science
Création de la notice
09/05/2013 14:38
Dernière modification de la notice
03/03/2018 13:29
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