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

Schade, Rogier P; Schinkel, Janke; Visser, Leo G; Van Dijk, J Marc C; Voormolen, Joan H C; Kuijper, Ed J · J Neurosurg · 2005

prospective_cohort · Level II

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Abstract

In the present study the authors compared the incidence and risk factors for external drainage-related bacterial meningitis (ED-BM) by using ventricular and lumbar catheters. A cohort of 230 consecutive patients with ED was evaluated. Cerebrospinal fluid samples were obtained daily for microbiological culture, and ED-BM was defined based on culture results in combination with clinical symptoms. The incidence of ED-BM was 7% in lumbar and 15% in ventricular drains. Independent risk factors included site leakage, drain blockage, and most importantly duration of ED. Despite a higher infection rate, ventricular catheters did not have a significant higher risk of infection after correcting for duration of drainage. Analysis of data in the present study showed that the incidence of ED-associated death is low (0.45%) in patients who do not receive continuous antibiotic prophylaxis during ED.

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