Comparison of Rates of Drain-Related Ventriculitis According to Definitions Used

To the Editor—We read with interest the recent comparison of ventricular drain-related ventriculitis (VDRV) according to which definitions were used.1 Reyes et al1 undertook a retrospective assessment of 52 cases of VDRV using 4 sets of definitions and found that using the National Healthcare Safety Network (NHSN) definitions resulted in substantially more cases of DDRV being identified. A high red blood cell count in the CSF, as might perhaps be expected in this group of patients, was statistically associated with CSF culture-negative cases.7 While the greater availability of molecular methods to diagnose VDRV may assist in determining the microbial cause, there will always be a need to assess a combination of clinical features, microbiological results, and other CSF parameters such as a protein levels, glucose levels, and cell counts. Establishing such definitions will facilitate comparisons between centers that can inform improvements in the care related to these invasive devices and, ultimately, in patient outcomes.