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. 2014:2014:708531.
doi: 10.1155/2014/708531. Epub 2014 Nov 17.

External ventricular drain infections: risk factors and outcome

S Hagel  1 , T Bruns  2 , M W Pletz  3 , C Engel  4 , R Kalff  5 , C Ewald  5
Affiliations

External ventricular drain infections: risk factors and outcome

S Hagel et al. Interdiscip Perspect Infect Dis. 2014.

Abstract

External ventricular drainage (EVD) is frequently used in neurosurgery to drain cerebrospinal fluid in patients with raised intracranial pressure. We performed a retrospective single center study in order to evaluate the incidence of EVD-related infections and to identify underlying risk factors. 246 EVDs were placed in 218 patients over a 30-month period. EVD was continued in median for 7 days (range 1-44). The cumulative incidence of EVD-related infections was 8.3% (95% CI, 5.3-12.7) with a device-associated infection rate of 10.4 per 1000 drainage days (95% CI, 6.2-16.5). The pathogens most commonly identified were coagulase-negative Staphylococcus (62%) followed by Enterococcus spp. (19%). Patients with an EVD-related infection had a significantly longer ICU (11 versus 21 days, P < 0.01) and hospital stay (20 versus 28.5 days, P < 0.01) than patients without. Median total duration of external drainage was twice as long in patients with EVD-related infection (6 versus 12 days, P < 0.01). However, there was no significant difference in the duration between first EVD placement and the occurrence of EVD-related infection and EVD removal in patients without EVD-related infection (6 versus 7 days, P = 0.87), respectively. Interestingly no risk factor for EVD-related infection could be identified in our cohort of patients.

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Figures

Figure 1
Figure 1
Occurrence of EVD-related infection related to drainage days after placement of EVD with underlying infection.
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