title: Factors contributing to ventriculostomy infection.
abstract: OBJECTIVE
  Catheter-related infection remains a cause of morbidity in the use of external ventricular drains (EVDs). The aim of this retrospective single-center study was to assess the rate and factors related to ventriculostomy infections in the setting of the published literature.
  
  
  METHODS
  Patients that underwent EVD placement in a single-center were retrospectively reviewed. Diagnosis, treatment, hospital course, and infection-related data were collected and analyzed in reference to ventriculitis rates. The protocols for EVD placement and maintenance were reviewed.
  
  
  RESULTS
  Of 343 patients, 12 acquired an EVD infection. No significant differences existed between those with and without ventriculitis for age, sex, underlying diagnosis, or concomitant systemic infection. Although not significant, concomitant systemic infection existed in 4.7% of patients with ventriculitis versus 1.5% without. There was a significant difference in length of EVD placement in patients with ventriculitis (20.9 ± 15.3 days) versus those without (12.1 ± 18.2; P = 0.005). Coagulase-negative Staphylococcus and Staphylococcus aureus represented the most commonly associated pathogens. With an overall cumulative incidence of 3.5%, our rate compared favorably to the published literature (cumulative incidence 9.5%; range, 3.9%-23.2%).
  
  
  CONCLUSIONS
  Catheter-related infection remains an important complication of EVD placement. Of factors evaluated, length of time of catheter placement has the most notable relationship to infection incidence, suggesting that early drain removal should be a goal whenever medically appropriate.
authors.affiliation: Department of Neurological Surgery, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Joon-Hyung
authors.initials: JH
authors.lastname: Kim
authors.forename: Naman S
authors.initials: NS
authors.lastname: Desai
authors.forename: Joseph
authors.initials: J
authors.lastname: Ricci
authors.forename: Philip E
authors.initials: PE
authors.lastname: Stieg
authors.forename: Axel J
authors.initials: AJ
authors.lastname: Rosengart
authors.forename: Roger
authors.initials: R
authors.lastname: Härtl
authors.forename: Justin F
authors.initials: JF
authors.lastname: Fraser
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000382:microbiology; D057785:Catheters; D002555:Cerebrospinal Fluid / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000209:etiology; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects; D014696:Ventriculostomy / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents