Comparing External Ventricular Drains-Related Ventriculitis Surveillance Definitions

Details

• Alternative Title:
  Infect Control Hosp Epidemiol
• Personal Author:
  Reyes, Maria ; Munigala, Satish ; Church, Emily ; Kulik, Tobias ; Keyrouz, Salah ; Zipfel, Gregory ; Warren, David K.
• Description:
  Objective ; To evaluate the agreement between the current National Healthcare Safety Network (NHSN) definition for ventriculitis and others found in the literature among patients with an external ventricular drain (EVD). ; Design ; Retrospective cohort study from January 2009 to December 2014 ; Setting ; Neurology and neurosurgery intensive care unit of a large tertiary care center. ; Patients ; Patients with an EVD. Patients with an infection prior to EVD placement or a permanent ventricular shunt were excluded. ; Methods ; We reviewed the charts of patients with a positive cerebrospinal fluid (CSF) cultures and/or abnormal CSF results while they had an EVD in place and applied various ventriculitis definitions. ; Results ; We identified 48 patients with a total of 52 episodes of ventriculitis (41 CSF culture positive episodes and 11 episodes based on abnormal CSF test results) using the NHSN definition. The most common organisms causing ventriculitis were Gram positive commensals (79.2%), however 45% of these had growth of only one colony on one piece of media. About 60% of the ventriculitis episodes by NHSN definition met Honda criteria, about 56% met Gozal criteria and 23% met Citerio’s definition. Honda vs. Gozal had a moderate agreement (Ƙ=0.528, p< 0.05) whereas Honda vs Citerio (Ƙ=0.338, p< 0.05) and Citerio vs Gozal (Ƙ=0.384, p< 0.05) comparisons had only fair agreements. ; Conclusions ; Agreement between published VAI definitions in this cohort was moderate to fair. A VAI surveillance definition that better defines contaminants is needed for more homogenous application of surveillance definitions between institutions and better comparison of rates.
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• Keywords:
  • definition
  • surveillance
  • ventriculitis
  • Adult
  • Aged
  • Cerebral Ventriculitis
  • Cerebrospinal Fluid
  • Cross Infection
  • Drainage
  • Female
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• Source:
  Infect Control Hosp Epidemiol. 38(5):574-579
• Pubmed ID:
  28219470
• Pubmed Central ID:
  PMC5417350
• Document Type:
  Journal Article
• Funding:
  U54 CK000162/CK/NCEZID CDC HHSUnited States/ ; U54 CK000609/CK/NCEZID CDC HHSUnited States/
• Volume:
  38
• Issue:
  5
• Download URL:
  https://stacks.cdc.gov/view/cdc/45530/cdc_45530_DS1.pdf
• File Type:
  [PDF - 384.61 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:8031d3de609946aa1b129e52cce1d5189066702bf3d1dffa1edbed777e257b95