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Healthcare-Associated Ventriculitis in Children during COVID-19 Pandemic: Clinical Characteristics and Outcome of a

Jesús David Licona-Enríquez1, María Guadalupe Labra-Zamora1, Alma Griselda Ramírez-Reyes2

  • 1Infectious Diseases Department, Pediatric Hospital, National Medical Center, XXI Century, Mexican Institute of Social Security, Mexico City 06720, Mexico.

Antibiotics (Basel, Switzerland)
|October 27, 2023
PubMed

Insights

Healthcare-associated ventriculitis (HAV) in children is a significant concern, especially during the COVID-19 pandemic. Younger age, malnutrition, and external ventricular drain (EVD) placement were linked to a first-time infection.

Area of Science:

  • Neurosurgery
  • Pediatric Infectious Diseases
  • Epidemiology

Background:

  • The COVID-19 pandemic impacted neurosurgical care, leading to postponed elective procedures and reduced emergency visits.
  • Healthcare-associated ventriculitis (HAV) poses a serious threat to pediatric patients, characterized by poor prognoses and recurrent infections.
  • Understanding the factors contributing to initial HAV infections in children during the pandemic is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate the clinical characteristics of children experiencing their first healthcare-associated ventriculitis (HAV).
  • To identify risk factors associated with the development of a first-time HAV in pediatric patients following cerebrospinal fluid diversion procedures during the COVID-19 pandemic.

Main Methods:

  • A retrospective cross-sectional study was conducted from January 2021 to December 2022.
  • Included were pediatric patients who developed a first HAV after cerebrospinal fluid diversion surgery; controls were patients without infection.
  • Data on intraoperative and clinical factors were collected from medical records.

Main Results:

  • Out of 199 cerebrospinal fluid diversion surgeries, 17 patients (8.5%) developed a first HAV, predominantly with external ventricular drains (EVDs).
  • Gram-positive cocci were the most common pathogens (70.6%).
  • Factors significantly associated with a first HAV included younger age (median 9 months), malnutrition, and EVD placement. Intraoperative factors did not show significant differences.

Conclusions:

  • The incidence of HAV in this pediatric cohort during the pandemic was notably high.
  • Young children, particularly those under one year old and those with EVDs, were most susceptible to developing HAV.
  • Malnutrition emerged as a significant risk factor, highlighting the need for nutritional support in vulnerable pediatric neurosurgical patients.

Keywords:
COVID-19 pandemicCSF (cerebrospinal fluid) diversion procedureshealthcare-associated ventriculitisneurosurgerysurgical site infection

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