Characteristics of Device-Associated Cerebrospinal Fluid Infection in Adults.
- Author:
So My KOO
1
;
Eun Jung LEE
;
Se Yoon PARK
;
Shi Nae YU
;
Min Young LEE
;
Tae Hyong KIM
;
Eun Ju CHOO
;
Min Huok JEON
Author Information
1. Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea. shegets@schmc.ac.kr
- Publication Type:Original Article
- Keywords:
Nosocomial bacterial meningitis;
Cerebrospinal fluid infection;
Device-associated;
Meningitis;
Cerebral ventriculitis
- MeSH:
Acinetobacter;
Adult*;
Anti-Bacterial Agents;
Central Nervous System;
Cerebral Ventriculitis;
Cerebrospinal Fluid*;
Diagnosis;
Fever;
Humans;
Meningitis;
Retrospective Studies;
Risk Factors;
Staphylococcus;
Treatment Failure;
Ventriculoperitoneal Shunt
- From:Soonchunhyang Medical Science
2013;19(2):51-55
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Device-associated infections in the central nervous system are serious complications of procedures involving indwelling devices among neurosurgical patients. In this study, the clinical characteristics and outcome of microbiologically confirmed device-associated cerebrospinal fluid (CSF) infection were evaluated. METHODS: We performed a retrospective analysis of adult patients found to have a positive CSF culture result during a hospital admission between 1 January 2005 through 2 October 2010 in Soonchunhyang University Hospital. RESULTS: During the study period, all episodes (n=161 CSF specimens, 87 patients) involving a culture-positive CSF were enrolled. Thirty-two episodes of device-associated CSF infection were included in the analysis among the study group. Most device-associated infections were ventriculo-peritoneal shunt infections (14/32, 44%). Fever (>38degrees C) was present in 17 episodes (53%). Overall, the most common microorganism was coagulase-negative staphylococcus (7/32 [22%]). Gram-negative rods (Pseudomonas aeruginosa 6/32 [19%], Acinetobacter baumannii/haemolyticus 5/32 [16%]) were identified in culture in 16/32 (50%). Device was removed for the control of device-associated infection in 30/32 (94%). Cure rate was 69% (22/32). All patients with treatment failure (10/32, 34%) expired. CONCLUSION: It is difficult to diagnosis device-associated CSF infections early since those are frequently presented with nonspecific clinical signs and symptoms. In our study, gram-negative infections accounted for 50% of cases and the empiric antibiotics initially chosen were found to not be effective against the final identified pathogen in many cases. Device-associated CSF infections should be strongly considered a serious risk factor associated with CSF infections, and prompt initiation of broad coverage antibiotics should be started after appropriate assessment.
