External Ventricular Drainage Infections: Experience from a Tertiary Care Center in Nepa

Abstract

Introduction: External Ventricular Drainage (EVD) is one of the most commonly performed procedures in neurosurgical practice. EVD related infection is among the most dreaded complications encountered after the procedure with added morbidity and mortality.

Objectives: The primary objective of this study was to assess the incidence of EVD infections in this hospital. In addition, the researchers have made an attempt to evaluate the indication for EVD placement, influence of total drainage time on the risk of catheter infection, the most common bacterial spectra in cerebrospinal fluid (CSF) culture, their antibiotic sensitivity pattern, and the association of CSF cell count with bacterial growth.

Methods: This is a retrospective study of all patients who underwent EVD placement over a period of two years. Those patients who had bacterial growth in their initial samples were excluded from the study.

Results: Out of 62 patients, 54 met the inclusion criteria for analysis. The ventricular catheters were in place from 1 to 23 days. Overall shunt infection rate was 37%. CSF cell count was significantly associated with the occurrence of a positive CSF culture (Fisher’s Exact Test, p<0.01). The most common bacterial species isolated were Acinetobacter baumannii and Burkholderia cepacia.

Conclusion: Despite many advances in care, there is still a significantly high incidence of EVD related infections. Contrary to earlier reports, the most common bacteria grown in the study were quite different and their antibiotic sensitivity varied accordingly.