Ventriculitis Complicating Use of Intraventricular Catheters in Adult Neurosurgical Patients

• Published in: Clinical infectious diseases Vol. 33; no. 12; pp. 2028 - 2033
• Main Authors: Lyke, K. E., Obasanjo, O. O., Williams, M. A., O'Brien, M., Chotani, R., Perl, T. M.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15-12-2001; University of Chicago Press
• Subjects: Adult; Aged; Antibiotics; Bacterial diseases; Bacterial diseases of the nervous system. Bacterial myositis; Biological and medical sciences; Cardiac Catheterization - adverse effects; Cardiac Catheterization - economics; Catheters; Catheters, Indwelling - adverse effects; Catheters, Indwelling - economics; Craniocerebral trauma; Female; Heart Ventricles; Hospital admissions; Human bacterial diseases; Humans; Infections; Infectious diseases; Intracranial pressure; Major Articles; Male; Medical sciences; Middle Aged; Outcome Assessment (Health Care); Pathogens; Predisposing factors; Prosthesis-Related Infections - economics; Prosthesis-Related Infections - microbiology; Risk Factors; Staphylococcus; Ventriculostomy; Human; Nervous system diseases; Use; Catheter; Cerebral ventricle; Ventriculitis; Cerebral disorder; Infection; Treatment; Surgery; Central nervous system disease; Risk factor; Bacteriosis; Adult; Complication; Staphylococcal infection
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/324492

Ventriculitis is a serious complication of intraventricular catheter (IVC) use, with rates of IVC-related infections ranging from 0% to 45% and gram-positive organisms predominating. We prospectively analyzed ventriculostomy-related infections occurring among 157 adult neurosurgical patients (mean age, 54.9 years; 90 [57%] were women) from 1995 through 1998, to determine the incidence of, risk factors for, and organisms that cause ventriculitis. A total of 196 IVC events resulted in 11 infections (5.6%; 9 were caused by gram-negative organisms and 2 by coagulase-negative staphylococci). Independent risk factors for IVC-related infection include length of IVC placement (8.5 days [infected] vs. 5.1 days [uninfected]; P = .007) and cerebrospinal fluid leakage about the IVC (P = .003). The length of hospital stay (30.8 days vs. 22.6 days; P = .03) and mean total hospital charges ($85,674.27 vs. $55,339.21; P = .009) were greater for infected patients than for uninfected patients. In addition, a microbiologic shift from gram-positive organisms toward gram-negative organisms was noted. This study suggests that IVC-related infections remain serious infections that increase the length of hospitalization.