Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016;30(1):49-56.
doi: 10.3109/02688697.2015.1080222. Epub 2015 Sep 15.

Ventriculostomy-related infections: The performance of different definitions for diagnosing infection

Ariane Lewis  1 , Sarah Wahlster  2   3 , Sarah Karinja  1   4 , Barry M Czeisler  1 , W Taylor Kimberly  2 , Aaron S Lord  1
Affiliations

Ventriculostomy-related infections: The performance of different definitions for diagnosing infection

Ariane Lewis et al. Br J Neurosurg. 2016.

Abstract

Introduction: Comparison of rates of ventriculostomy-related infections (VRIs) across institutions is difficult due to the lack of a standard definition. We sought to review published definitions of VRI and apply them to a test cohort to determine the degree of variability in VRI diagnosis.

Materials and methods: We conducted a PubMed search for definitions of VRI using the search strings "ventriculostomy-related infection" and "ventriculostomy-associated infection." We applied these definitions to a test cohort of 18 positive cerebrospinal fluid (CSF) cultures taken from ventriculostomies at two institutions to compare the frequency of infection using each definition.

Results: We found 16 unique definitions of VRI. When the definitions were applied to the test cohort, the frequency of infection ranged from 22 to 94% (median 61% with interquartile range (IQR) 56-74%). The concordance between VRI diagnosis and treatment with VRI-directed antibiotics for at least seven days ranged from 56 to 89% (median: 72%, IQR: 71-78%).

Conclusions: The myriad of definitions in the literature produce widely different frequencies of infection. In order to compare rates of VRI between institutions for the purposes of qualitative metrics and research, a consistent definition of VRI is needed.

Keywords: CSF shunt; cerebrospinal fluid; infection; surgical-site infection; ventriculitis.

PubMed Disclaimer

Conflict of interest statement

Declaration of Interest

Ariane Lewis, Sarah Wahlster, Sarah Karinja, and Barry Czeisler do not have any financial conflicts of interest. Aaron Lord received support from the NYU-HHC Clinical and Translational Science Institute via grant UL1 TR000038 from the National Center for Advancing Translational Sciences of the National Institutes of Health. W. Taylor Kimberly receives support from the Andrew David Heitman Neurovascular Research Foundation. The Foundation had no role in study design, collection, analysis, interpretation of data, writing of the manuscript, or decision to submit the manuscript for publication.

Figures

Figure I
Figure I
Diagnosis of Ventriculostomy-Related Infection (VRI) This bar graph demonstrates the variation in percentage of cultures in the test cohort diagnosed as ventriculostomy-related infections.
See this image and copyright information in PMC

References

    1. Srinivasan VM, O’Neill BR, Jho D, Whiting DM, Oh MY. The history of external ventricular drainage. J Neurosurg. 2014;120:228–36. - PubMed
    1. Le Roux P, Menon DK, Citerio G, Vespa P, Bader MK, Brophy GM, et al. Consensus Summary Statement of the International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care. Neurocrit Care. 2014 - PMC - PubMed
    1. Definitions S. CDC / NHSN Surveillance Definitions for Specific Types of Infections. 2014.
    1. Lyke KE, Obasanjo OO, Williams MA, O’Brien M, Chotani R, Perl TM. Ventriculitis complicating use of intraventricular catheters in adult neurosurgical patients. Clin Infect Dis. 2001;33:2028–33. - PubMed
    1. Williams T, Leslie GD, Dobb GJ, Roberts B, van Heerden PV. Decrease in proven ventriculitis by reducing the frequency of cerebrospinal fluid sampling from extraventricular drains. J Neurosurg. 2011;115:1040–6. - PubMed

Publication types

MeSH terms

Substances