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KMID : 1201420140070020097
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Journal of Neurocritical Care
2014 Volume.7 No. 2 p.97 ~ p.103
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Prevention and Management of Extraventricular Drain-Related Ventriculitis
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Choi Sang-Ho
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Abstract
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Ventriculitis after extraventricular drain (EVD) placement causes significant morbidity and mortality. This review is focused on the prevention and management of EVD-related ventriculitis. To prevent EVD-related ventriculitis, standardized EVD care, including sterile handling and strict infection control performances, and repeated education for healthcare workers are essential. Routine change of EVD is controversial. It can be considered when EVD is needed for more than 7 days. Perioperative antibiotic prophylaxis beyond 24 hours is not recommended, except for cerebrospinal fluid (CSF) leakage. Antibiotic-impregnated EVD catheter seems to reduce the incidence of EVD-related ventriculitis. CSF sampling for early detection of EVD-related ventriculitis can be considered 4 to 5 days after EVD insertion. Linezolid can be used for treating ventriculitis caused by multidrug-resistant Gram-positive organisms. Treatment options for extensively drug-resistant or pandrug resistant Gram-negative bacilli are scarce. Intraventricular colistin or aminoglycoside can be considered for those conditions.
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KEYWORD
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Cerebral ventriculitis, Ventriculostomy, Cerebrospinal fluid
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