Infection rates in standard vs. hydrogel coated ventricular catheters

Area of Science:

• Neurosurgery
• Infectious Diseases
• Biomaterials

Background:

• External ventricular drain (EVD) use is associated with significant neurosurgical infection risks.
• Hydrophilic modified catheters aim to reduce bacterial adherence and cerebrospinal fluid (CSF) infections.
• Preventing catheter-related infections is crucial for patient outcomes.

Purpose of the Study:

• To compare the incidence of CSF infection between standard silastic and hydrogel-coated EVD catheters.
• To evaluate the efficacy of modified catheters in reducing infection rates.
• To assess the impact of presoaking catheters in bacitracin solution.

Main Methods:

• Prospective randomized clinical trial at three university centers.
• Adult neurosurgery patients receiving a first EVD were enrolled.
• Catheters were presoaked in bacitracin; infection defined by CSF culture results.

Main Results:

• 158 patients were analyzed; no significant difference in infection rates between catheter types.
• Overall infection rate was 8% (definite or probable).
• Infection incidence increased from day 2 to day 11, irrespective of catheter coating.

Conclusions:

• Hydrogel-coated EVD catheters, even when presoaked in bacitracin, did not reduce CSF infection rates.
• Infection remains a common complication associated with EVD use.
• Novel strategies are required to mitigate EVD-related infections.