Silver-Coated Ventriculostomy Catheters Do Not Reduce Rates of Clinically Diagnosed Ventriculitis.
Identifieur interne : 000402 ( Main/Corpus ); précédent : 000401; suivant : 000403Silver-Coated Ventriculostomy Catheters Do Not Reduce Rates of Clinically Diagnosed Ventriculitis.
Auteurs : Anna Nilsson ; Erik Uvelius ; David Cederberg ; Erik KronvallSource :
- World neurosurgery [ 1878-8769 ] ; 2018.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Anti-Bacterial Agents (administration & dosage), Catheter-Related Infections (prevention & control), Catheterization (adverse effects), Catheterization (instrumentation), Cerebral Hemorrhage (surgery), Cerebral Ventriculitis (prevention & control), Cerebrospinal Fluid Shunts (adverse effects), Cerebrospinal Fluid Shunts (instrumentation), Drainage (adverse effects), Drainage (instrumentation), Female (MeSH), Humans (MeSH), Length of Stay (MeSH), Male (MeSH), Middle Aged (MeSH), Retrospective Studies (MeSH), Silver (administration & dosage), Subarachnoid Hemorrhage (surgery), Treatment Failure (MeSH), Ventriculostomy (adverse effects), Ventriculostomy (instrumentation), Young Adult (MeSH).
- MESH :
- chemical , administration & dosage : Anti-Bacterial Agents, Silver.
- adverse effects : Catheterization, Cerebrospinal Fluid Shunts, Drainage, Ventriculostomy.
- instrumentation : Catheterization, Cerebrospinal Fluid Shunts, Drainage, Ventriculostomy.
- prevention & control : Catheter-Related Infections, Cerebral Ventriculitis.
- surgery : Cerebral Hemorrhage, Subarachnoid Hemorrhage.
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Length of Stay, Male, Middle Aged, Retrospective Studies, Treatment Failure, Young Adult.
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 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.
DOI: 10.1016/j.wneu.2018.06.045
PubMed: 29920387
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Silver-Coated Ventriculostomy Catheters Do Not Reduce Rates of Clinically Diagnosed Ventriculitis.</title><author><name sortKey="Nilsson, Anna" sort="Nilsson, Anna" uniqKey="Nilsson A" first="Anna" last="Nilsson">Anna Nilsson</name><affiliation><nlm:affiliation>Department of Clinical Sciences Lund, Neurosurgery, Skåne University Hospital, Lund University, Lund, Sweden. Electronic address: anna.ac.nilsson@skane.se.</nlm:affiliation></affiliation></author><author><name sortKey="Uvelius, Erik" sort="Uvelius, Erik" uniqKey="Uvelius E" first="Erik" last="Uvelius">Erik Uvelius</name><affiliation><nlm:affiliation>Department of Clinical Sciences Lund, Neurosurgery, Skåne University Hospital, Lund University, Lund, Sweden.</nlm:affiliation></affiliation></author><author><name sortKey="Cederberg, David" sort="Cederberg, David" uniqKey="Cederberg D" first="David" last="Cederberg">David Cederberg</name><affiliation><nlm:affiliation>Department of Clinical Sciences Lund, Neurosurgery, Skåne University Hospital, Lund University, Lund, Sweden.</nlm:affiliation></affiliation></author><author><name sortKey="Kronvall, Erik" sort="Kronvall, Erik" uniqKey="Kronvall E" first="Erik" last="Kronvall">Erik Kronvall</name><affiliation><nlm:affiliation>Department of Clinical Sciences Lund, Neurosurgery, Skåne University Hospital, Lund University, Lund, Sweden.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2018">2018</date><idno type="RBID">pubmed:29920387</idno><idno type="pmid">29920387</idno><idno type="doi">10.1016/j.wneu.2018.06.045</idno><idno type="wicri:Area/Main/Corpus">000402</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000402</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Silver-Coated Ventriculostomy Catheters Do Not Reduce Rates of Clinically Diagnosed Ventriculitis.</title><author><name sortKey="Nilsson, Anna" sort="Nilsson, Anna" uniqKey="Nilsson A" first="Anna" last="Nilsson">Anna Nilsson</name><affiliation><nlm:affiliation>Department of Clinical Sciences Lund, Neurosurgery, Skåne University Hospital, Lund University, Lund, Sweden. Electronic address: anna.ac.nilsson@skane.se.</nlm:affiliation></affiliation></author><author><name sortKey="Uvelius, Erik" sort="Uvelius, Erik" uniqKey="Uvelius E" first="Erik" last="Uvelius">Erik Uvelius</name><affiliation><nlm:affiliation>Department of Clinical Sciences Lund, Neurosurgery, Skåne University Hospital, Lund University, Lund, Sweden.</nlm:affiliation></affiliation></author><author><name sortKey="Cederberg, David" sort="Cederberg, David" uniqKey="Cederberg D" first="David" last="Cederberg">David Cederberg</name><affiliation><nlm:affiliation>Department of Clinical Sciences Lund, Neurosurgery, Skåne University Hospital, Lund University, Lund, Sweden.</nlm:affiliation></affiliation></author><author><name sortKey="Kronvall, Erik" sort="Kronvall, Erik" uniqKey="Kronvall E" first="Erik" last="Kronvall">Erik Kronvall</name><affiliation><nlm:affiliation>Department of Clinical Sciences Lund, Neurosurgery, Skåne University Hospital, Lund University, Lund, Sweden.</nlm:affiliation></affiliation></author></analytic><series><title level="j">World neurosurgery</title><idno type="eISSN">1878-8769</idno><imprint><date when="2018" type="published">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Anti-Bacterial Agents (administration & dosage)</term><term>Catheter-Related Infections (prevention & control)</term><term>Catheterization (adverse effects)</term><term>Catheterization (instrumentation)</term><term>Cerebral Hemorrhage (surgery)</term><term>Cerebral Ventriculitis (prevention & control)</term><term>Cerebrospinal Fluid Shunts (adverse effects)</term><term>Cerebrospinal Fluid Shunts (instrumentation)</term><term>Drainage (adverse effects)</term><term>Drainage (instrumentation)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Length of Stay (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>Silver (administration & dosage)</term><term>Subarachnoid Hemorrhage (surgery)</term><term>Treatment Failure (MeSH)</term><term>Ventriculostomy (adverse effects)</term><term>Ventriculostomy (instrumentation)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Anti-Bacterial Agents</term><term>Silver</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Catheterization</term><term>Cerebrospinal Fluid Shunts</term><term>Drainage</term><term>Ventriculostomy</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Catheterization</term><term>Cerebrospinal Fluid Shunts</term><term>Drainage</term><term>Ventriculostomy</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Catheter-Related Infections</term><term>Cerebral Ventriculitis</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Cerebral Hemorrhage</term><term>Subarachnoid Hemorrhage</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Length of Stay</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term><term>Treatment Failure</term><term>Young Adult</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>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></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">29920387</PMID><DateCompleted><Year>2018</Year><Month>10</Month><Day>16</Day></DateCompleted><DateRevised><Year>2018</Year><Month>10</Month><Day>16</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1878-8769</ISSN><JournalIssue CitedMedium="Internet"><Volume>117</Volume><PubDate><Year>2018</Year><Month>Sep</Month></PubDate></JournalIssue><Title>World neurosurgery</Title><ISOAbbreviation>World Neurosurg</ISOAbbreviation></Journal><ArticleTitle>Silver-Coated Ventriculostomy Catheters Do Not Reduce Rates of Clinically Diagnosed Ventriculitis.</ArticleTitle><Pagination><MedlinePgn>e411-e416</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S1878-8750(18)31260-9</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.wneu.2018.06.045</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="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.</AbstractText><AbstractText Label="METHODS" NlmCategory="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.</AbstractText><AbstractText Label="RESULTS" NlmCategory="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.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="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.</AbstractText><CopyrightInformation>Copyright © 2018 Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Nilsson</LastName><ForeName>Anna</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Clinical Sciences Lund, Neurosurgery, Skåne University Hospital, Lund University, Lund, Sweden. Electronic address: anna.ac.nilsson@skane.se.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Uvelius</LastName><ForeName>Erik</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Clinical Sciences Lund, Neurosurgery, Skåne University Hospital, Lund University, Lund, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cederberg</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Clinical Sciences Lund, Neurosurgery, Skåne University Hospital, Lund University, Lund, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kronvall</LastName><ForeName>Erik</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Clinical Sciences Lund, Neurosurgery, Skåne University Hospital, Lund University, Lund, Sweden.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2018</Year><Month>06</Month><Day>18</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>World Neurosurg</MedlineTA><NlmUniqueID>101528275</NlmUniqueID><ISSNLinking>1878-8750</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000900">Anti-Bacterial Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>3M4G523W1G</RegistryNumber><NameOfSubstance UI="D012834">Silver</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000900" MajorTopicYN="N">Anti-Bacterial Agents</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D055499" MajorTopicYN="N">Catheter-Related Infections</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002404" MajorTopicYN="N">Catheterization</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000295" MajorTopicYN="N">instrumentation</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002543" MajorTopicYN="N">Cerebral Hemorrhage</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058565" MajorTopicYN="N">Cerebral Ventriculitis</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002557" MajorTopicYN="N">Cerebrospinal Fluid Shunts</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000295" MajorTopicYN="N">instrumentation</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004322" MajorTopicYN="N">Drainage</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000295" MajorTopicYN="N">instrumentation</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007902" MajorTopicYN="N">Length of Stay</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012834" MajorTopicYN="N">Silver</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013345" MajorTopicYN="N">Subarachnoid Hemorrhage</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017211" MajorTopicYN="N">Treatment Failure</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014696" MajorTopicYN="N">Ventriculostomy</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000295" MajorTopicYN="Y">instrumentation</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Bactericidal coating</Keyword><Keyword MajorTopicYN="N">External ventricular drain</Keyword><Keyword MajorTopicYN="N">Humans</Keyword><Keyword MajorTopicYN="N">Intracranial pressure</Keyword><Keyword MajorTopicYN="N">Silver coating</Keyword><Keyword MajorTopicYN="N">Ventriculitis</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>04</Month><Day>24</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2018</Year><Month>06</Month><Day>05</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2018</Year><Month>06</Month><Day>06</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2018</Year><Month>6</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2018</Year><Month>10</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2018</Year><Month>6</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">29920387</ArticleId><ArticleId IdType="pii">S1878-8750(18)31260-9</ArticleId><ArticleId IdType="doi">10.1016/j.wneu.2018.06.045</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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