title: Early monitoring of ventriculostomy-related infections with procalcitonin in patients with ventricular drains.
abstract: Several factors are implicated in the increased vulnerability of multiple trauma victims to infection, especially in intensive care units. The incidence of EVD related infections ranges from 5 to 20%. To assess the accuracy of serum procalcitonin (PCT) in predicting central nervous system (CNS) infection in patients with EVDs. Thirty-six adult patients with severe head trauma were enrolled in this prospective study, after exclusion of other causes of fever; patients were subjected to sampling of C-reactive protein (CRP), PCT, and cerebrospinal fluid (CSF) cultures every other day. Five patients developed ventriculostomy-related infections, and all had an elevated serum PCT concentration. Patients with negative CSF cultures had mean serum PCT <2.0 ng/ml, while patients with positive culture had early elevation of serum PCT with mean of 4.18 ng/ml, CRP did not show similar early changes. Patients who acquire CNS infection had prolonged length of stay in hospital and length of ventilation. In absence of other nosocomial infections, early high serum PCT concentrations appear to be a reliable indicator of bacterial CNS infection in patients with EVD.
authors: Department of Cardiothoracic Surgery/Cardiac Anaesthesia & ICU Section, Heart Hospital, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar. a_s_omar@yahoo.com.|Faculty of Medicine, Beni Suef University, Beni Suef, Egypt. a_s_omar@yahoo.com.
authors: Amr S
authors: AS
authors: Omar
authors: Tawam Hospital, Abu Dhabi, UAE. shawarby@hotmail.com.|Mounofia University, Al-Minufya, Egypt. shawarby@hotmail.com.
authors: Amr
authors: A
authors: ElShawarby
authors: Biostatistics, Medial Research Department, Hamad Medical Corporation, Doha, Qatar. rsingh@hmc.org.qa.
authors: Rajvir
authors: R
authors: Singh
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D020806:Central Nervous System Bacterial Infections / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D003428:Cross Infection / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D014696:Ventriculostomy / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide
keywords: External ventricular drain; Meningitis; Procacitonin
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