Infections associated with indwelling ventriculostomy catheters in a teaching hospital.
BACKGROUND
Ventriculostomy-associated infections are a serious complication of external ventricular drains. The objective of this study was to analyze the clinical features of and risk factors for such infections.


METHODS
We retrospectively collected demographic and clinical data on patients with indwelling ventriculostomy catheters hospitalized in a teaching hospital from July 2001 to June 2006, comparing those with and without ventriculostomy-associated infections.


RESULTS
A total of 197 drains (2910 catheter-days) placed in 155 patients were studied. Infections developed in 28 of the 197 (14.2%) drains. The duration from insertion to infection ranged from 7 to 36 days. The cut-off point of duration from insertion to infection was 15.5 days. Re-insertion because of catheter malfunction carried a high risk of infection (p<0.001). Patients with infections had a longer intensive care unit stay (p=0.001), longer duration of catheterization (p=0.002), and a higher incidence of concurrent sepsis (p=0.018), urinary tract infection (p=0.011) and pneumonia (p=0.004). Gram-negative bacilli were the leading pathogens (84%); Pseudomonas aeruginosa was the most common isolate. Polymicrobial infections occurred later than monomicrobial infections (p=0.003).


CONCLUSIONS
Repeated insertion and longer duration of drains are major risk factors for ventriculostomy-associated infections.
Chi
Hsin
H
Committee of Infection Control, Mackay Memorial Hospital, Taitung Branch, 1, Lane 303, Changsha Street, Taitung, Taiwan.
Chang
Kuan-Yu
KY
Chang
Hong-Chang
HC
Chiu
Nan-Chang
NC
Huang
Fu-Yuan
FY
D000328:Adult; D000368:Aged; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000382:microbiology*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002494:Central Nervous System Infections / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014696:Ventriculostomy / Q000009:adverse effects*