Ventriculitis complicating use of intraventricular catheters in adult neurosurgical patients.
Ventriculitis is a serious complication of intraventricular catheter (IVC) use, with rates of IVC-related infections ranging from 0% to 45% and gram-positive organisms predominating. We prospectively analyzed ventriculostomy-related infections occurring among 157 adult neurosurgical patients (mean age, 54.9 years; 90 [57%] were women) from 1995 through 1998, to determine the incidence of, risk factors for, and organisms that cause ventriculitis. A total of 196 IVC events resulted in 11 infections (5.6%; 9 were caused by gram-negative organisms and 2 by coagulase-negative staphylococci). Independent risk factors for IVC-related infection include length of IVC placement (8.5 days [infected] vs. 5.1 days [uninfected]; P=.007) and cerebrospinal fluid leakage about the IVC (P=.003). The length of hospital stay (30.8 days vs. 22.6 days; P=.03) and mean total hospital charges ($85,674.27 vs. $55,339.21; P=.009) were greater for infected patients than for uninfected patients. In addition, a microbiologic shift from gram-positive organisms toward gram-negative organisms was noted. This study suggests that IVC-related infections remain serious infections that increase the length of hospitalization.
Lyke
K E
KE
Division of Infectious Diseases, The Johns Hopkins University, Baltimore, MD, 21205, USA. klyke@jhmi.edu or klyke@medicine.umaryland.edu
Obasanjo
O O
OO
Williams
M A
MA
O'Brien
M
M
Chotani
R
R
Perl
T M
TM
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000191:economics; D002408:Catheters, Indwelling / Q000009:adverse effects* / Q000191:economics; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016459:Prosthesis-Related Infections / Q000191:economics / Q000382:microbiology*; D012307:Risk Factors; D014696:Ventriculostomy