BACKGROUND: External ventricular drains (EVDs) are associated with high rates of infection, and EVD infections cause substantial morbidity and mortality. OBJECTIVE: To determine whether the introduction of an evidence-based EVD infection control protocol could reduce the rate of EVD infections. METHODS: This was a retrospective analysis of an EVD infection control protocol introduced in a tertiary care neurointensive care unit. We compared rates of cerebrospinal fluid culture positivity and ventriculitis for the 3 years before and 3 years after the introduction of an evidence-based EVD infection control protocol. A total of 262 EVD placements were analyzed, with a total of 2499 catheter-days. RESULTS: The rate of cerebrospinal fluid culture positivity decreased from 9.8% (14 of 143; 11.43 per 1000 catheter-days) at baseline to 0.8% (1 of 119; 0.79 per 1000 catheter-days) in the EVD infection control protocol period (P = .001). The rate of ventriculitis decreased from 6.3% (9 of 143; 7.35 per 1000 catheter-days) to 0.8% (1 of 119; 0.79 per 1000 catheter-days; P = .02). CONCLUSION: The introduction of a simple, evidence-based infection control protocol was associated with a dramatic reduction in the risk of EVD infection.
BACKGROUND: External ventricular drains (EVDs) are associated with high rates of infection, and EVD infections cause substantial morbidity and mortality. OBJECTIVE: To determine whether the introduction of an evidence-based EVD infection control protocol could reduce the rate of EVD infections. METHODS: This was a retrospective analysis of an EVD infection control protocol introduced in a tertiary care neurointensive care unit. We compared rates of cerebrospinal fluid culture positivity and ventriculitis for the 3 years before and 3 years after the introduction of an evidence-based EVD infection control protocol. A total of 262 EVD placements were analyzed, with a total of 2499 catheter-days. RESULTS: The rate of cerebrospinal fluid culture positivity decreased from 9.8% (14 of 143; 11.43 per 1000 catheter-days) at baseline to 0.8% (1 of 119; 0.79 per 1000 catheter-days) in the EVD infection control protocol period (P = .001). The rate of ventriculitis decreased from 6.3% (9 of 143; 7.35 per 1000 catheter-days) to 0.8% (1 of 119; 0.79 per 1000 catheter-days; P = .02). CONCLUSION: The introduction of a simple, evidence-based infection control protocol was associated with a dramatic reduction in the risk of EVD infection.
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Authors: Aimun A B Jamjoom; Alexis J Joannides; Michael Tin-Chung Poon; Aswin Chari; Malik Zaben; Mutwakil A H Abdulla; Joy Roach; Laurence J Glancz; Anna Solth; John Duddy; Paul M Brennan; Roger Bayston; Diederik O Bulters; Conor L Mallucci; Michael D Jenkinson; William P Gray; Jothy Kandasamy; Peter J Hutchinson; Angelos G Kolias; Aminul I Ahmed Journal: J Neurol Neurosurg Psychiatry Date: 2017-10-25 Impact factor: 13.654