Abstract

Background and objectiveHealthcare-associated ventriculitis and meningitis (HAVM) is frequent in neurocritical patients and associated with significant mortality. Surgery and intracranial devices are usually necessary and may lead to infection. Classical clinical signs and cerebral spinal fluid (CSF) analysis may be unreliable. The purpose of this study was to characterize the prevalence of HAVM, risk factors, and interventions in the neurocritical population admitted in the ICU.MethodsThis was a retrospective single-center analysis of all adult neurocritical patients admitted to an ICU during a three-year period.ResultsA total of 218 neurocritical patients were included. The prevalence of HAVM was 13% and it was found to be associated with mortality. When suspected, it was not possible to exclude HAVM in 30% of the patients. HAVM was significantly associated with surgery, surgical reintervention, and brain devices. Sustained fever was the most frequent clinical sign, and it was significantly associated with unexcluded HAVM. CSF cell count was significantly higher in HAVM, though without microbiological isolation in most of the cases.ConclusionBrain damage, interventions, and devices may significantly alter cerebral homeostasis. Sustained fever is very frequent and may be attributed to several conditions. CSF cell count is useful for the diagnosis of HAVM. HAVM is a clinical challenge in the management of neurocritical patients with important therapeutic and prognostic implications.

Highlights

  • Healthcare-associated ventriculitis and meningitis (HAVM) is linked with a wide range of incidence in the literature, varying from 1 to 25% [1,2,3]

  • HAVM was significantly associated with surgery, surgical reintervention, and brain devices

  • Sustained fever was the most frequent clinical sign, and it was significantly associated with unexcluded HAVM

Read more

Summary

Introduction

Healthcare-associated ventriculitis and meningitis (HAVM) is linked with a wide range of incidence in the literature, varying from 1 to 25% [1,2,3]. Surgery and brain devices are frequently necessary to manage neurocritical patients, but they may result in contamination and colonization [4,5,6]. The diagnosis of HAVM is based on clinical signs and cerebral spinal fluid (CSF) analysis. Classical clinical signs and symptoms, such as fever, neck stiffness, and altered mental status, are insensitive and unreliable in HAVM and manifest fully only in a minority of cases [1,7]. CSF cultures are considered the reference standard and the most important test for diagnosis of HAVM but can be negative in a broad proportion of cases [1,7]. Healthcare-associated ventriculitis and meningitis (HAVM) is frequent in neurocritical patients and associated with significant mortality. Classical clinical signs and cerebral spinal fluid (CSF) analysis may be unreliable. The purpose of this study was to characterize the prevalence of HAVM, risk factors, and interventions in the neurocritical population admitted in the ICU

Objectives
Methods
Results
Conclusion
Full Text
Paper version not known

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.