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Silver-Coated Ventriculostomy Catheters Do Not Reduce Rates of Clinically Diagnosed Ventriculitis

Nilsson, Anna; Uvelius, Erik LU ; Cederberg, David LU and Kronvall, Erik LU (2018) In World Neurosurgery 117. p.411-416
Abstract

Background: Ventriculitis is a serious complication when using external ventricular drains (EVDs). Bactericidal silver coating has been reported to reduce risk of infection. In the clinical setting, the diagnosis is often made based on symptoms and analyses of cerebrospinal fluid, with treatment initiated before infection is verified by culture. The bactericidal effect might not correlate with a reduced rate of clinically diagnosed infections. This retrospective study aimed to analyze if use of silver-coated EVDs is associated with a reduced rate of ventriculitis. Methods: During 1 year, clinical routine was changed from inserting noncoated catheters to silver-coated catheters. Rate of ventriculitis was compared between patient groups... (More)

Background: Ventriculitis is a serious complication when using external ventricular drains (EVDs). Bactericidal silver coating has been reported to reduce risk of infection. In the clinical setting, the diagnosis is often made based on symptoms and analyses of cerebrospinal fluid, with treatment initiated before infection is verified by culture. The bactericidal effect might not correlate with a reduced rate of clinically diagnosed infections. This retrospective study aimed to analyze if use of silver-coated EVDs is associated with a reduced rate of ventriculitis. Methods: During 1 year, clinical routine was changed from inserting noncoated catheters to silver-coated catheters. Rate of ventriculitis was compared between patient groups based on catheter type. To examine the clinical impact of silver coating, ventriculitis was defined as cases where antibiotic treatment was initiated on clinical suspicion. Results: Among 296 patients (186 noncoated and 110 silver-coated catheters), 18.9% were treated for ventriculitis, with 21.0% in the noncoated group and 15.5% in the silver-coated group (P = 0.242). Silver coating did not reduce the rate of positive cultures. Duration of EVD treatment was the single significant risk factor for ventriculitis. Silver-coated catheters did not reduce the need for cerebrospinal fluid shunt placement, days with antibiotics, days with EVD, or days in the intensive care unit. Conclusions: The previously reported bactericidal effect of silver-coated EVDs did not alter the clinical course to significantly reduce the number of treated cases of ventriculitis. The introduction of silver-coated EVDs cannot be motivated by reduced use of antibiotics or shorter hospital stay.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bactericidal coating, External ventricular drain, Humans, Intracranial pressure, Silver coating, Ventriculitis
in
World Neurosurgery
volume
117
pages
411 - 416
publisher
Elsevier
external identifiers
  • scopus:85049839223
ISSN
1878-8750
DOI
10.1016/j.wneu.2018.06.045
language
English
LU publication?
yes
id
f866a3fe-76d9-448e-981b-17ed5140ec0a
date added to LUP
2018-07-31 10:43:09
date last changed
2019-01-14 17:46:55
@article{f866a3fe-76d9-448e-981b-17ed5140ec0a,
  abstract     = {<p>Background: Ventriculitis is a serious complication when using external ventricular drains (EVDs). Bactericidal silver coating has been reported to reduce risk of infection. In the clinical setting, the diagnosis is often made based on symptoms and analyses of cerebrospinal fluid, with treatment initiated before infection is verified by culture. The bactericidal effect might not correlate with a reduced rate of clinically diagnosed infections. This retrospective study aimed to analyze if use of silver-coated EVDs is associated with a reduced rate of ventriculitis. Methods: During 1 year, clinical routine was changed from inserting noncoated catheters to silver-coated catheters. Rate of ventriculitis was compared between patient groups based on catheter type. To examine the clinical impact of silver coating, ventriculitis was defined as cases where antibiotic treatment was initiated on clinical suspicion. Results: Among 296 patients (186 noncoated and 110 silver-coated catheters), 18.9% were treated for ventriculitis, with 21.0% in the noncoated group and 15.5% in the silver-coated group (P = 0.242). Silver coating did not reduce the rate of positive cultures. Duration of EVD treatment was the single significant risk factor for ventriculitis. Silver-coated catheters did not reduce the need for cerebrospinal fluid shunt placement, days with antibiotics, days with EVD, or days in the intensive care unit. Conclusions: The previously reported bactericidal effect of silver-coated EVDs did not alter the clinical course to significantly reduce the number of treated cases of ventriculitis. The introduction of silver-coated EVDs cannot be motivated by reduced use of antibiotics or shorter hospital stay.</p>},
  author       = {Nilsson, Anna and Uvelius, Erik and Cederberg, David and Kronvall, Erik},
  issn         = {1878-8750},
  keyword      = {Bactericidal coating,External ventricular drain,Humans,Intracranial pressure,Silver coating,Ventriculitis},
  language     = {eng},
  month        = {01},
  pages        = {411--416},
  publisher    = {Elsevier},
  series       = {World Neurosurgery},
  title        = {Silver-Coated Ventriculostomy Catheters Do Not Reduce Rates of Clinically Diagnosed Ventriculitis},
  url          = {http://dx.doi.org/10.1016/j.wneu.2018.06.045},
  volume       = {117},
  year         = {2018},
}