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Bacterial meningitis caused by the use of ventricular or lumbar cerebrospinal fluid catheters

Rogier P Schade1, Janke Schinkel, Leo G Visser

  • 1Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands. r.schade@mmb.umcn.nl

Journal of Neurosurgery
|March 3, 2005
PubMed
Abstract

Insights

This study found that while ventricular drains have a higher incidence of bacterial meningitis (BM), the risk is similar to lumbar drains when adjusted for drainage duration. Key risk factors for external drainage-related BM include site leakage and drain blockage.

Area of Science:

  • Infectious Diseases
  • Neurosurgery
  • Medical Microbiology

Background:

  • External drainage (ED) is crucial for managing cerebrospinal fluid (CSF) but carries a risk of bacterial meningitis (BM).
  • Comparing infection rates and risk factors between different types of external drains is essential for patient safety.

Purpose of the Study:

  • To compare the incidence and risk factors of external drainage-related bacterial meningitis (ED-BM) using ventricular and lumbar catheters.
  • To identify independent risk factors associated with ED-BM.

Main Methods:

  • A cohort of 230 patients with external drains was evaluated.
  • Daily cerebrospinal fluid samples were cultured, and ED-BM was diagnosed based on clinical symptoms and culture results.
  • Statistical analysis was performed to identify independent risk factors.

Main Results:

  • The incidence of ED-BM was 7% for lumbar drains and 15% for ventricular drains.
  • Independent risk factors for ED-BM included site leakage, drain blockage, and duration of ED.
  • Despite a higher raw infection rate, ventricular catheters did not show a significantly higher risk of infection after adjusting for drainage duration.

Conclusions:

  • The incidence of ED-associated death was low (0.45%) in patients not receiving continuous antibiotic prophylaxis.
  • Drainage duration is a critical factor influencing the risk of ED-BM.
  • Careful management of drain sites and blockages is important to reduce infection risk.

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