Strategies to reduce external ventricular drain-related infections: a multicenter retrospective study
| العنوان: | Strategies to reduce external ventricular drain-related infections: a multicenter retrospective study |
|---|---|
| المؤلفون: | Laurent Gergelé, Jean-François Payen, Clément Mourey, Nicolas Bruder, Romain Manet, Julia Champey, Gilles Francony, Lionel Velly, Patricia Pavese |
| المساهمون: | Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), INSERM U836, équipe 5, Neuro-imagerie fonctionnelle et métabolique, Grenoble Institut des Neurosciences (GIN), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service d'anesthésie-réanimation, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon-CHU Grenoble-Hôpital Michallon, Service des Maladies Infectieuses, CHU Grenoble, Département de neurochirurgie, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Assistance Publique - Hôpitaux de Marseille (APHM), Institut de Neurosciences de la Timone (INT), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Réanimation Polyvalente, Hôpital de la Timone [CHU - APHM] (TIMONE), Neuro-imagerie fonctionnelle et métabolique (ANTE-INSERM U836, équipe 5), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne) |
| المصدر: | Journal of Neurosurgery Journal of Neurosurgery, 2018, pp.1-6 Journal of Neurosurgery, American Association of Neurological Surgeons, 2018, pp.1-6 |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | medicine.medical_specialty, business.industry, Incidence (epidemiology), Retrospective cohort study, General Medicine, medicine.disease, Intensive care unit, 3. Good health, law.invention, 03 medical and health sciences, 0302 clinical medicine, CSF pleocytosis, law, Internal medicine, Intensive care, medicine, Ventriculitis, Cumulative incidence, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], 030212 general & internal medicine, business, 030217 neurology & neurosurgery, ComputingMilieux_MISCELLANEOUS, External ventricular drain |
| الوصف: | OBJECTIVEVarious strategies have been proposed to reduce the incidence of external ventricular drain (EVD)–related infections. The authors retrospectively studied the impact of EVD care management on EVD-related infections at 3 French university hospital intensive care units.METHODSBetween 2010 and 2014, 462 consecutive adult patients with no evidence of a preexisting CSF infection received EVDs as part of their care at one of the following sites: Grenoble (221 patients), Saint-Etienne (130 patients), and Marseille (111 patients). Written protocols describing the EVD placement procedure, management, and removal were implemented at the 3 sites. Daily CSF sampling and intraventricular administration of antibiotics prior to EVD removal were performed at the Grenoble site only. EVD-related infection was considered for any confirmed ventriculostomy-related infection (VRI) and ventriculitis. VRI was defined as one or more positive CSF cultures or Gram stain with CSF pleocytosis and biochemical abnormalities. Ventriculitis was defined as CSF pleocytosis and biochemical abnormalities with degradation of neurological status and fever.RESULTSA total of 6945 EVD days were observed in the entire population. In the Grenoble cohort, the mean cumulative incidence of EVD-related infections was significantly lower than that in the 2 other cohorts: 1.4% (95% CI 0.0%–2.9%) versus 9.2% (95% CI 4.2%–14.2%) and 7.2% (95% CI 2.4%–12.0%) at Saint-Etienne and Marseille, respectively (p < 0.01). Accounting for the duration of external ventricular drainage at each site, the risk for EVD-related CSF infections was significantly higher at Saint-Etienne and Marseille than at Grenoble, with ORs of 15.9 (95% CI 3.6–71.4, p < 0.001) and 10.0 (95% CI 2.2–45.5, p = 0.003), respectively.CONCLUSIONSThese findings indicate that it is possible to attain a low incidence of EVD-related infections, provided that an EVD care bundle, which can include routine daily CSF sampling, is implemented and strongly adhered to. |
| تدمد: | 1933-0693 0022-3085 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dffe6835fc42d03764812691674474a7 https://pubmed.ncbi.nlm.nih.gov/29932377 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....dffe6835fc42d03764812691674474a7 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19330693 00223085 |
|---|