Ventriculitis caused by multidrug-resistant bacteria in a medical intensive care unit with limited resources
Pedja Kovacevic, Sasa Dragic, Vlado Djajic
Central nervous system infections, cerebrospinal fluid drains, cerebrospinal fluid shunt, meningitis, ventriculitis
Citation Information :
Kovacevic P, Dragic S, Djajic V. Ventriculitis caused by multidrug-resistant bacteria in a medical intensive care unit with limited resources. Indian J Crit Care Med 2018; 22 (11):814-816.
The widespread use of various devices in the diagnosis or treatment of critically ill neurological patients has led to the more frequent appearance of a new group of meningitis and ventriculitis caused by resistant Gram-negative bacteria or staphylococci. In literature, it has been labeled as health care-associated meningitis and ventriculitis. In our clinical practice (in resource-limited countries), we still have any viable experience neither in the application of these diagnostic and therapeutic tools nor in the handling of complications resulting from their use. However, we have had positive results with the help of the existing guidelines and advice from colleagues in the region (through a video consultation model) while also respecting other factors that reflect our work environment.
Tunkel AR, Hasbun R, Bhimraj A, Byers K, Kaplan SL, Michael Scheld W, et al. 2017 infectious diseases society of America's clinical practice guidelines for healthcare-associated ventriculitis and meningitis. Clin Infect Dis 2017;64:e34-e65.
Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 2004;39:1267-84.
Mayhall CG, Archer NH, Lamb VA, Spadora AC, Baggett JW, Ward JD, et al. Ventriculostomy-related infections. A prospective epidemiologic study. N Engl J Med 1984;310:553-9.
McGirt MJ, Zaas A, Fuchs HE, George TM, Kaye K, Sexton DJ, et al. Risk factors for pediatric ventriculoperitoneal shunt infection and predictors of infectious pathogens. Clin Infect Dis 2003;36:858-62.
Conen A, Walti LN, Merlo A, Fluckiger U, Battegay M, Trampuz A, et al. Characteristics and treatment outcome of cerebrospinal fluid shunt-associated infections in adults: A retrospective analysis over an 11-year period. Clin Infect Dis 2008;47:73-82.
Piatt JH Jr., Carlson CV. A search for determinants of cerebrospinal fluid shunt survival: Retrospective analysis of a 14-year institutional experience. Pediatr Neurosurg 1993;19:233-41.