Cerebrospinal fluid drainage-related ventriculitis due to multidrug-resistant microorganisms

Abstract

Introduction: The aim of the study was to analyze the clinical and microbiological characteristics of adult patients with cerebrospinal fluid (CSF) drainage-related ventriculitis.

Methods: Retrospective study from January 2010 to June 2019 performed in the Complexo Hospitalario Universitario de Vigo (Spain). Cases of CSF drainage-related ventriculitis in patients ≥18-year-old were gathered. Clinical characteristics of patients, type of drainage devices, management and microbiological isolates were analyzed.

Results: Ninety-one episodes of CSF drainage-related ventriculitis were identified. The most frequent organisms isolated were Gram-positive cocci (65%), mainly Staphylococcus epidermidis (48%). Multidrug-resistant microorganisms were detected in 21 episodes (23%). In multivariate analysis, the independent factors related with multidrug-resistant ventriculitis were the length of hospital stay >14 days (HR 6.7; 95%CI 1.75-25.86, p=0.006) and previous antimicrobial therapy (HR 5.58; 95%CI 1.44-21.65, p=0.013).

Conclusions: Our study shows a large number of drainage-related ventriculitis episodes caused by multidrug-resistant organisms and reinforce the importance of a judicious use of antibiotics.

Keywords: Bacterias multirresistentes; Cerebrospinal fluid drainage-related ventriculitis; Device removal; Mortalidad; Mortality; Multidrug-resistant microorganisms; Retirada del dispositivo; Tratamiento; Treatment; Ventriculitis asociada a dispositivo de drenaje de líquido cefalorraquídeo.