Ventriculitis as a complication of a external ventricular drainage

Abstract

Introduction: Ventriculitis is the infection of the cerebral ventricles that may appear as a complication of an external ventricular drainage (EVD). The management of EVD and ventriculitis prevention, diagnosis and treatment are controversial topics.

Objective: To determine the origin and risk factors of ventriculitis resulting from EVDs.

Methods: The research consists of two parts: bibliographic research and database analysis. In the second part, a retrospective descriptive study has been carried out that includes patients who have had an EVD implanted in the UCI at Donostia University Hospital from 1st January to 31st December 2023. The incidence of ventriculitis, the microbiological agent and risk factors (days of EVD implantation, previous antiaggregation or anticoagulation and mortality) have been analysed.

Results: Of the 34 cases analysed, all have had EDV implanted and 20.6% have developed ventriculitis. The causes of the introduction of an EDV have been subarachnoid bleeding (58.8%), intraparenchimal or intraventricular bleeding (35.4%) and complications of ventriculoperitoneal shunts (5.8%). Patients had EDV implanted for 11.5 days on average, 55.88% for more than 7 days. Staphylococcus epidermidis has been the etiological agent in 62.5% of the cases. Mortality has not been described in the ventriculitis group.

Conclusion: The percentage of ventriculitis that develops at Donostia University Hospital as a result of the introduction of an EDV has been the same as described in the literature (20.6% vs 1.9-36%). EDV implantation for more than 7 days (p = 0.013) has been described as risk factors. There is a need for further research on the subject in the future.