title: Efficacy of antibiotic-impregnated external ventricular drains in reducing ventriculostomy-associated infections.
abstract: Use of an external ventricular drain (EVD) is essential for managing patients with hydrocephalus or intracranial hypertension. While this procedure is safe and efficacious, ventriculostomy-associated infections (VAI) continue to cause significant morbidity. In this study, we evaluated the efficacy of antibiotic-coated EVD (AC-EVD) in reducing the occurrence of VAI. Between July 2007 and July 2009, 203 patients underwent placement of an EVD. A total of 145 of these patients met the inclusion criteria, with 76 patients (52.4%) receiving AC-EVD and 69 patients (47.6%) receiving uncoated EVD. Ten patients (6.9%) developed VAI, of whom three were in the AC-EVD group and seven were in the uncoated EVD group (p=0.19). The mean duration between catheter insertion and positive cerebrospinal fluid culture was significantly greater in the AC-EVD group versus the uncoated EVD group (15±4days versus 4±2days, respectively; p=0.001). In the uncoated EVD group, 17 of 69 patients (24.6%) were dead at 3years versus 12 of 76 (15.8%) patients in the AC-EVD group (p=0.21). The overall VAI rate was 6.9% with a trend toward lower infection rates in the AC-EVD group compared to the uncoated EVD group (3.9% versus 10.1%, respectively; p>0.05).
authors.affiliation: Department of Neurosurgery, University of Michigan, 1500 E. Medical Center Drive, Room 3552 TC, Ann Arbor, MI 48109-5338, USA.
authors.forename: Yana
authors.initials: Y
authors.lastname: Mikhaylov
authors.affiliation: Department of Neurosurgery, University of Michigan, 1500 E. Medical Center Drive, Room 3552 TC, Ann Arbor, MI 48109-5338, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wilson
authors.affiliation: Department of Neurosurgery, University of Michigan, 1500 E. Medical Center Drive, Room 3552 TC, Ann Arbor, MI 48109-5338, USA.
authors.forename: Venkatakrishna
authors.initials: V
authors.lastname: Rajajee
authors.affiliation: Department of Neurosurgery, University of Michigan, 1500 E. Medical Center Drive, Room 3552 TC, Ann Arbor, MI 48109-5338, USA.
authors.forename: B Gregory
authors.initials: BG
authors.lastname: Thompson
authors.affiliation: Department of Neurosurgery, University of Michigan, 1500 E. Medical Center Drive, Room 3552 TC, Ann Arbor, MI 48109-5338, USA.
authors.forename: Cormac O
authors.initials: CO
authors.lastname: Maher
authors.affiliation: Department of Neurosurgery, University of Michigan, 1500 E. Medical Center Drive, Room 3552 TC, Ann Arbor, MI 48109-5338, USA.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Sullivan
authors.affiliation: Department of Neurosurgery, University of Michigan, 1500 E. Medical Center Drive, Room 3552 TC, Ann Arbor, MI 48109-5338, USA.
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Jacobs
authors.affiliation: Department of Neurosurgery, University of Michigan, 1500 E. Medical Center Drive, Room 3552 TC, Ann Arbor, MI 48109-5338, USA.
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Kocan
authors.affiliation: Department of Neurosurgery, University of Michigan, 1500 E. Medical Center Drive, Room 3552 TC, Ann Arbor, MI 48109-5338, USA. Electronic address: adityap@med.umich.edu.
authors.forename: Aditya S
authors.initials: AS
authors.lastname: Pandey
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D004322:Drainage / Q000009:adverse effects* / Q000295:instrumentation; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014696:Ventriculostomy / Q000009:adverse effects* / Q000295:instrumentation
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; External ventricular drain; Ventriculitis; Ventriculostomy catheter; Ventriculostomy-associated infection