![]() The study also revealed a significant correlation between intracranial infection and a CSF leak or a drainage (either ventricular or lumbar) and number of craniotomies.Īs compared to community acquired intracranial infections, the distribution of causative organisms are different in health care associated infections, which are associated with normal flora of skin and nasopharynx such as Streptococcus pneumonia, staphylococci, and gram-negative organism ( 11, 12). ![]() Similarly, a study done on 520 patients, admitted following a traumatic brain injury (TBI), showed that 6.54% suffered from an intracranial infection ( 10). Another study indicated that 3 to 29% of sub-arachnoid hemorrhage (SAH) patients suffered from bacterial ventriculitis, mainly those who received cerebrospinal fluid (CSF) diversion via a catheter ( 6– 9). Two large series studies reported its incidence ranging from 0.3 to 1.5% in patients who had a neurosurgical procedure ( 4, 5). The incidence of health care associated intracranial infection varies according to the type of insults. According to the CDC, it is defined as a localized or systemic condition resulting from an adverse reaction to the presence of an infectious agent(s) or its toxin(s), without any evidence that the infection was present or incubating at the time of admission ( 2), and can be seen within 48 h to a week following a hospital discharge ( 3). Health care associated intracranial infections are often encountered in neurosurgical patients ( 1). Prompt recognition and management of these patients is absolutely crucial for significant reduction on morbidity and mortality rates. Morbidity and mortality of these patients depends on several factors: type of an organism involved and its sensitivity to the available antibiotics, location as-well as severity of infections such as localized brain abscess or ventriculitis. It presents with different clinical syndromes such as meningitis, encephalitis, brain abscess, and ventriculitis, etc. Sixteen patients (84%) were cured, and 3 patients (15%) died during the course of the treatment.Ĭonclusion: In addition to Intraventricular Colistin, thorough ventricular irrigation could increase the cure rate up to 84% in patients suffering from MDR/XDR CNS ventriculitis.Ĭentral nervous system infections are caused by wide range of microorganisms. The average CSF sterilization period following ventricular irrigation and intraventricular Colistin was 6 days. Fourteen patients had Acinetobacter baumannii (AB) and 5 had Klebsiella pneumoniae (KP). Results: A total of 19 patients were included (15 males and 4 females), with a mean age in years of 51, which ranged from 18–67. Treatment outcomes were evaluated based on the clinical symptoms, Cerebro-Spinal Fluid (CSF) culture, laboratory findings and complications. We reviewed our experience the role of thorough ventricular irrigation with Colistin mixed normal saline, followed by intraventricular Colistin therapy. Materials and Methods: A retrospective analysis was done on 19 inpatients with ventriculitis caused by Acinetobacter baumannii (AB) or Klebsiella pneumonia (KP), at Shanghai Tenth People's Hospital from January 2016 to October 2017. Infections due to multi/extensive drug resistance (MDR/XDR) microorganisms are very challenging, which may demand an additional approach to the ongoing practice intravenous and intraventricular administration of antibiotics.Īim: To study the efficacy and safety of thorough ventricular irrigation followed by daily intraventricular antibiotic administration in patients with MDR/XDR ventriculitis. Introduction: CNS ventriculitis is a serious complication following an intracranial insult that demands immediate treatment with broad-spectrum antibiotics in a critical care setting. 2Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.1Neurosurgery Department, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.Sajan Pandey 1,2 †, Lei Li 1,2 †, Xian Yu Deng 1,2, Da Ming Cui 1 * and Liang Gao 1,2
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