Characteristics and outcomes of cerebrospinal fluid shunt and drain-associated infections - 05/05/23
, Isabelle Patry b, Catherine Chirouze a, c, Kevin Bouiller a, cHighlights |
• | Cerebrospinal Fluid Shunt or drain infections were responsible for high mortality rates. |
• | Deceased patients more frequently had a decreasing of Glasgow coma scale score. |
• | Cerebrospinal fluid monitoring significantly helped to detect patients with poor prognosis in cerebrospinal drain infections. |
Abstract |
Introduction |
Data on infections associated with cerebrospinal fluid shunt (CSF-S) or device-associated infection (CSF-SDI) are limited in adults. We performed a retrospective study to describe characteristics, management, and outcome of CSF-SDI.
Methods |
All patients with CSF-SDI and admitted to our institution from January 2013 to December 2019 were included.
Results |
Among 50 patients, fifty-six episodes of CSF-SDI (41 external ventricular device-associated infections (CSF-D) and 15 other shunt infections (CSF-S) were included. The incidence of CSF-SDI was 11.9 %. Fever was the most common symptom (81 %). Enterobacterales were more prevalent in CSF-S than in CSF-D (20 % vs 53 %, p = 0.02). As regards CSF-D, deceased patients (11/41, 27 %) more frequently had a Glasgow coma scale score decreasing from baseline (p < 0.01), lower glycorrhachia (p < 0.01), a higher protein level in CSF (p = 0.001) and a positive control CSF culture (p = 0.031).
Conclusions |
CSF-SDIs are rare but with a high mortality rate. Mortality was more closely related to the infection than to comorbidities or underlying neurosurgical disease. A second CSF analysis significantly helped to detect patients with CSF-D with a poor prognosis.
Le texte complet de cet article est disponible en PDF.Keywords : Healthcare-associated, Meningitis, Ventriculitis, Cerebrospinal fluid shunt, Cerebral drain
Plan
Vol 53 - N° 3
Article 104665- avril 2023 Retour au numéro
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