Surveillance and management of ventriculitis following neurosurgery.

摘要: Ventriculitis is an important complication following neurosurgery and often associated with the use of external ventricular drain (EVD). The incidence varies from <5% to 20%, partly due variations in definitions used for diagnosis. Staphylococci are most causes but isolation coagulase-negative staphylococci a cerebrospinal fluid (CSF) sample needs be interpreted caution as it may represent contamination. Risk factors ventriculitis include advanced age, duration EVD placement, number manipulations presence intraventricular haemorrhage. Prevention strategies increasingly focus on implementation care bundle that includes aseptic technique at time insertion during any manipulations, skin preparation, prophylactic antibiotics, appropriate dressings site EVD. EVDs impregnated antimicrobial agents increasing but, whereas some studies show these effective, not clear whether they provide added benefit when there compliance other measures. Antimicrobial treatment challenging many widely do penetrate into CSF causative bacteria multidrug resistant. Often combination high-dose intravenous required, especially Gram-negative infections. Large trials this area conduct; therefore, better inform preventive optimize management condition, ongoing national surveillance pooling data approaches outcomes needed.