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Infected ventriculostomy: bacteriology and treatment
J K Ohrström1, J K Skou, T Ejlertsen
1Department of Neurosurgery, Aalborg Hospital, Denmark.
Acta Neurochirurgica
|January 1, 1989
Summary
Ventriculostomy can lead to cerebrospinal fluid (CSF) infections, often caused by skin bacteria. Prompt antibiotic treatment, both intravenous and intrathecal, proved highly effective with minimal side effects.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Pharmacology
Background:
- Ventriculostomy is a common first-line surgical procedure.
- Cerebrospinal fluid (CSF) infections are a significant complication following ventriculostomy.
- Gram-positive cocci, typical of skin flora, are the primary causative agents.
Purpose of the Study:
- To determine the incidence of CSF infections after ventriculostomy.
- To evaluate the effectiveness of combined intravenous and intrathecal antibiotic therapy.
- To assess the safety profile of the antibiotic treatment regimen.
Main Methods:
- Retrospective analysis of 256 patients undergoing ventriculostomy.
- Monitoring for CSF infections over a 6-year period.
- Administration of tailored intravenous and intrathecal antibiotics based on sensitivity testing.
Main Results:
- An 11% incidence of CSF infections was observed in the study cohort.
- Gram-positive cocci accounted for nearly 90% of identified infections.
- Simultaneous intravenous and intrathecal antibiotic treatment demonstrated high efficacy and safety.
Conclusions:
- Ventriculostomy carries an 11% risk of CSF infection, predominantly from skin flora.
- Combined antibiotic therapy is an effective and safe treatment for post-ventriculostomy CSF infections.
- Early and targeted antibiotic intervention is crucial for managing these infections.