title: A simple protocol to prevent external ventricular drain infections.
abstract: BACKGROUND
  External ventricular drains (EVDs) are associated with high rates of infection, and EVD infections cause substantial morbidity and mortality.
  
  
  OBJECTIVE
  To determine whether the introduction of an evidence-based EVD infection control protocol could reduce the rate of EVD infections.
  
  
  METHODS
  This was a retrospective analysis of an EVD infection control protocol introduced in a tertiary care neurointensive care unit. We compared rates of cerebrospinal fluid culture positivity and ventriculitis for the 3 years before and 3 years after the introduction of an evidence-based EVD infection control protocol. A total of 262 EVD placements were analyzed, with a total of 2499 catheter-days.
  
  
  RESULTS
  The rate of cerebrospinal fluid culture positivity decreased from 9.8% (14 of 143; 11.43 per 1000 catheter-days) at baseline to 0.8% (1 of 119; 0.79 per 1000 catheter-days) in the EVD infection control protocol period (P = .001). The rate of ventriculitis decreased from 6.3% (9 of 143; 7.35 per 1000 catheter-days) to 0.8% (1 of 119; 0.79 per 1000 catheter-days; P = .02).
  
  
  CONCLUSIONS
  The introduction of a simple, evidence-based infection control protocol was associated with a dramatic reduction in the risk of EVD infection.
authors: Kaiser Permanente, Department of Neuroscience, Redwood City, California 94063, USA. alexander.c.flint@kp.org
authors: Alexander C
authors: AC
authors: Flint
authors: Vivek A
authors: VA
authors: Rao
authors: Natalie C
authors: NC
authors: Renda
authors: Bonnie S
authors: BS
authors: Faigeles
authors: Todd E
authors: TE
authors: Lasman
authors: William
authors: W
authors: Sheridan
mesh_terms: D000368:Aged; D055499:Catheter-Related Infections / Q000209:etiology / Q000517:prevention & control*; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000382:microbiology; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D004322:Drainage / Q000009:adverse effects; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies