Surveillance and management of ventriculitis following neurosurgery
Summary Ventriculitis is an important complication following neurosurgery and is often associated with the use of an external ventricular drain (EVD). The incidence varies from
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| Veröffentlicht in: | The Journal of hospital infection 2015-04, Vol.89 (4), p.281-286 |
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| creator | Humphreys, H Jenks, P.J |
| description | Summary Ventriculitis is an important complication following neurosurgery and is often associated with the use of an external ventricular drain (EVD). The incidence varies from |
| doi_str_mv | 10.1016/j.jhin.2014.12.019 |
| format | Article |
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The incidence varies from <5% to 20%, partly due to variations in the definitions used for diagnosis. Staphylococci are the most important causes but the isolation of coagulase-negative staphylococci from a cerebrospinal fluid (CSF) sample needs to be interpreted with caution as it may represent contamination. Risk factors for ventriculitis include advanced age, the duration of EVD placement, the number of manipulations and the presence of intraventricular haemorrhage. Prevention strategies increasingly focus on the implementation of a care bundle that includes aseptic technique at the time of insertion and during any manipulations, skin preparation, prophylactic antibiotics, and appropriate dressings at the site of the EVD. The use of EVDs impregnated with antimicrobial agents is increasing but, whereas some studies show that these are effective, it is not clear whether they provide added benefit when there is compliance with other measures. Antimicrobial treatment is challenging as many widely used agents do not penetrate into the CSF and causative bacteria are increasingly multidrug resistant. Often a combination of high-dose intravenous and intraventricular agents is required, especially for Gram-negative infections. Large trials in this area are challenging to conduct; therefore, to better inform preventive strategies and to optimize management of this important condition, ongoing national surveillance and pooling of data on treatment approaches and outcomes are needed.</description><identifier>ISSN: 0195-6701</identifier><identifier>EISSN: 1532-2939</identifier><identifier>DOI: 10.1016/j.jhin.2014.12.019</identifier><identifier>PMID: 25687249</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Anti-Bacterial Agents - therapeutic use ; Cerebral Ventriculitis - diagnosis ; Cerebral Ventriculitis - drug therapy ; Cerebral Ventriculitis - epidemiology ; Cerebral Ventriculitis - prevention & control ; Drainage - methods ; External ventricular drain ; Humans ; Incidence ; Infectious Disease ; Neurosurgery ; Neurosurgical Procedures - adverse effects ; Prevention ; Risk Factors ; Surgical Wound Infection - diagnosis ; Surgical Wound Infection - drug therapy ; Surgical Wound Infection - epidemiology ; Surgical Wound Infection - prevention & control ; Treatment ; Ventriculitis/meningitis</subject><ispartof>The Journal of hospital infection, 2015-04, Vol.89 (4), p.281-286</ispartof><rights>The Healthcare Infection Society</rights><rights>2015 The Healthcare Infection Society</rights><rights>Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c514t-b4081b869d59f96503caa34255e773322156080adbd42f13e44c0023879e010f3</citedby><cites>FETCH-LOGICAL-c514t-b4081b869d59f96503caa34255e773322156080adbd42f13e44c0023879e010f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jhin.2014.12.019$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25687249$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Humphreys, H</creatorcontrib><creatorcontrib>Jenks, P.J</creatorcontrib><title>Surveillance and management of ventriculitis following neurosurgery</title><title>The Journal of hospital infection</title><addtitle>J Hosp Infect</addtitle><description>Summary Ventriculitis is an important complication following neurosurgery and is often associated with the use of an external ventricular drain (EVD). The incidence varies from <5% to 20%, partly due to variations in the definitions used for diagnosis. Staphylococci are the most important causes but the isolation of coagulase-negative staphylococci from a cerebrospinal fluid (CSF) sample needs to be interpreted with caution as it may represent contamination. Risk factors for ventriculitis include advanced age, the duration of EVD placement, the number of manipulations and the presence of intraventricular haemorrhage. Prevention strategies increasingly focus on the implementation of a care bundle that includes aseptic technique at the time of insertion and during any manipulations, skin preparation, prophylactic antibiotics, and appropriate dressings at the site of the EVD. The use of EVDs impregnated with antimicrobial agents is increasing but, whereas some studies show that these are effective, it is not clear whether they provide added benefit when there is compliance with other measures. Antimicrobial treatment is challenging as many widely used agents do not penetrate into the CSF and causative bacteria are increasingly multidrug resistant. Often a combination of high-dose intravenous and intraventricular agents is required, especially for Gram-negative infections. Large trials in this area are challenging to conduct; therefore, to better inform preventive strategies and to optimize management of this important condition, ongoing national surveillance and pooling of data on treatment approaches and outcomes are needed.</description><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Cerebral Ventriculitis - diagnosis</subject><subject>Cerebral Ventriculitis - drug therapy</subject><subject>Cerebral Ventriculitis - epidemiology</subject><subject>Cerebral Ventriculitis - prevention & control</subject><subject>Drainage - methods</subject><subject>External ventricular drain</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infectious Disease</subject><subject>Neurosurgery</subject><subject>Neurosurgical Procedures - adverse effects</subject><subject>Prevention</subject><subject>Risk Factors</subject><subject>Surgical Wound Infection - diagnosis</subject><subject>Surgical Wound Infection - drug therapy</subject><subject>Surgical Wound Infection - epidemiology</subject><subject>Surgical Wound Infection - prevention & control</subject><subject>Treatment</subject><subject>Ventriculitis/meningitis</subject><issn>0195-6701</issn><issn>1532-2939</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc2r1DAUxYMovvHpP-BCunTTmpuvJiCCDH7BAxdP1yGT3o6pbfpM2pH5702ZpwsX4urC5ZzDvb9DyHOgDVBQr4Zm-BZiwyiIBlhDwTwgO5Cc1cxw85DsykbWqqVwRZ7kPFBKy14-JldMKt0yYXZkf7umE4ZxdNFj5WJXTS66I04Yl2ruq1OZKfh1DEvIVT-P4_wzxGMVcU1zXtMR0_kpedS7MeOz-3lNvr5_92X_sb75_OHT_u1N7SWIpT4IquGglemk6Y2SlHvnuGBSYttyzhhIRTV13aETrAeOQnhKGdetQQq059fk5SX3Ls0_VsyLnUL2uN2O85otKF2waMXFf0iV0VwLLouUXaS-PJQT9vYuhcmlswVqN852sBtnu3G2wGyhWkwv7vPXw4TdH8tvsEXw-iLAAuQUMNnsAxbGXUjoF9vN4d_5b_6y-zHE4N34Hc-Yh3lNsaC2YHMx2Nut6a1okKVkCcB_Ad1MojM</recordid><startdate>20150401</startdate><enddate>20150401</enddate><creator>Humphreys, H</creator><creator>Jenks, P.J</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope></search><sort><creationdate>20150401</creationdate><title>Surveillance and management of ventriculitis following neurosurgery</title><author>Humphreys, H ; Jenks, P.J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c514t-b4081b869d59f96503caa34255e773322156080adbd42f13e44c0023879e010f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Cerebral Ventriculitis - diagnosis</topic><topic>Cerebral Ventriculitis - drug therapy</topic><topic>Cerebral Ventriculitis - epidemiology</topic><topic>Cerebral Ventriculitis - prevention & control</topic><topic>Drainage - methods</topic><topic>External ventricular drain</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infectious Disease</topic><topic>Neurosurgery</topic><topic>Neurosurgical Procedures - adverse effects</topic><topic>Prevention</topic><topic>Risk Factors</topic><topic>Surgical Wound Infection - diagnosis</topic><topic>Surgical Wound Infection - drug therapy</topic><topic>Surgical Wound Infection - epidemiology</topic><topic>Surgical Wound Infection - prevention & control</topic><topic>Treatment</topic><topic>Ventriculitis/meningitis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Humphreys, H</creatorcontrib><creatorcontrib>Jenks, P.J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><jtitle>The Journal of hospital infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Humphreys, H</au><au>Jenks, P.J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surveillance and management of ventriculitis following neurosurgery</atitle><jtitle>The Journal of hospital infection</jtitle><addtitle>J Hosp Infect</addtitle><date>2015-04-01</date><risdate>2015</risdate><volume>89</volume><issue>4</issue><spage>281</spage><epage>286</epage><pages>281-286</pages><issn>0195-6701</issn><eissn>1532-2939</eissn><abstract>Summary Ventriculitis is an important complication following neurosurgery and is often associated with the use of an external ventricular drain (EVD). The incidence varies from <5% to 20%, partly due to variations in the definitions used for diagnosis. Staphylococci are the most important causes but the isolation of coagulase-negative staphylococci from a cerebrospinal fluid (CSF) sample needs to be interpreted with caution as it may represent contamination. Risk factors for ventriculitis include advanced age, the duration of EVD placement, the number of manipulations and the presence of intraventricular haemorrhage. Prevention strategies increasingly focus on the implementation of a care bundle that includes aseptic technique at the time of insertion and during any manipulations, skin preparation, prophylactic antibiotics, and appropriate dressings at the site of the EVD. The use of EVDs impregnated with antimicrobial agents is increasing but, whereas some studies show that these are effective, it is not clear whether they provide added benefit when there is compliance with other measures. Antimicrobial treatment is challenging as many widely used agents do not penetrate into the CSF and causative bacteria are increasingly multidrug resistant. Often a combination of high-dose intravenous and intraventricular agents is required, especially for Gram-negative infections. Large trials in this area are challenging to conduct; therefore, to better inform preventive strategies and to optimize management of this important condition, ongoing national surveillance and pooling of data on treatment approaches and outcomes are needed.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>25687249</pmid><doi>10.1016/j.jhin.2014.12.019</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Anti-Bacterial Agents - therapeutic use Cerebral Ventriculitis - diagnosis Cerebral Ventriculitis - drug therapy Cerebral Ventriculitis - epidemiology Cerebral Ventriculitis - prevention & control Drainage - methods External ventricular drain Humans Incidence Infectious Disease Neurosurgery Neurosurgical Procedures - adverse effects Prevention Risk Factors Surgical Wound Infection - diagnosis Surgical Wound Infection - drug therapy Surgical Wound Infection - epidemiology Surgical Wound Infection - prevention & control Treatment Ventriculitis/meningitis |
| title | Surveillance and management of ventriculitis following neurosurgery |
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