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External ventricular and lumbar drainage-associated meningoventriculitis: prospective analysis of time-dependent

S Scheithauer1, U Bürgel, J Bickenbach

  • 1Department of Infection Control and Infectious Diseases, University Hospital, RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany. sscheithauer@ukaachen.de

Infection
|March 25, 2010
PubMed
Abstract

Insights

Meningoventriculitis (MV) infection rates are higher with lumbar drainage (LD) than external ventricular drainage (EVD). Most infections occur within 12 days, with highest rates between days 4-9, despite longer drainage reducing risk.

Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Limited data exist on the time-dependency of meningoventriculitis (MV) associated with external ventricular drainage (EVD) and lumbar drainage (LD).
  • Previous studies have controversial discussions and lack infection rates (IR) relative to drainage-days.

Purpose of the Study:

  • To determine time-dependent infection rates (IR) of EVD- and LD-associated meningoventriculitis (MV).
  • To perform a risk factor analysis for MV development.

Main Methods:

  • An observational study of 210 patients requiring EVD or LD over 18 months.
  • Data collected included drainage type, duration, ICP, manipulations, hospital stay, and MV time point.
  • Statistical analysis was performed to identify time-dependent IRs and risk factors.

Main Results:

  • 34 MV cases reported (17 EVD, 17 LD), with IRs of 7.5 and 24.7 MV/1000 drainage-days, respectively.
  • 82% of MV cases occurred within the first 12 days; highest IRs were observed between days 4-9.
  • Significant risk factors for MV included LD (vs. EVD), prior MV, and neoplasm; longer drainage duration correlated with lower MV risk.

Conclusions:

  • This study provides novel data on the time dependency of EVD- and LD-associated MV-IR.
  • Larger studies are needed to confirm findings and identify preventable risk factors.
  • Defining high-risk periods is crucial for early diagnosis and management of MV.

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