Prospective, multicentre study of external ventricular drainage-related infections in the UK and Ireland
dc.contributor.author | Jamjoom, AAB | |
dc.contributor.author | Joannides, AJ | |
dc.contributor.author | Poon, MT-C | |
dc.contributor.author | Chari, A | |
dc.contributor.author | Zaben, M | |
dc.contributor.author | Abdulla, MAH | |
dc.contributor.author | Roach, J | |
dc.contributor.author | Glancz, LJ | |
dc.contributor.author | Solth, A | |
dc.contributor.author | Duddy, J | |
dc.contributor.author | Brennan, PM | |
dc.contributor.author | Bayston, R | |
dc.contributor.author | Bulters, DO | |
dc.contributor.author | Mallucci, CL | |
dc.contributor.author | Jenkinson, MD | |
dc.contributor.author | Gray, WP | |
dc.contributor.author | Kandasamy, J | |
dc.contributor.author | Hutchinson, PJ | |
dc.contributor.author | Kolias, AG | |
dc.contributor.author | Ahmed, AI | |
dc.date.accessioned | 2019-11-25T21:41:46Z | |
dc.date.available | 2019-11-25T21:41:46Z | |
dc.date.issued | 2018-02 | |
dc.identifier.issn | 0022-3050 | |
dc.identifier.issn | 1468-330X | |
dc.identifier.uri | http://hdl.handle.net/10026.1/15179 | |
dc.description.abstract |
<jats:sec><jats:title>Objectives</jats:title><jats:p>External ventricular drain (EVD) insertion is a common neurosurgical procedure. EVD-related infection (ERI) is a major complication that can lead to morbidity and mortality. In this study, we aimed to establish a national ERI rate in the UK and Ireland and determine key factors influencing the infection risk.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A prospective multicentre cohort study of EVD insertions in 21 neurosurgical units was performed over 6 months. The primary outcome measure was 30-day ERI. A Cox regression model was used for multivariate analysis to calculate HR.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 495 EVD catheters were inserted into 452 patients with EVDs remaining in situ for 4700 days (median 8 days; IQR 4–13). Of the catheters inserted, 188 (38%) were antibiotic-impregnated, 161 (32.5%) were plain and 146 (29.5%) were silver-bearing. A total of 46 ERIs occurred giving an infection risk of 9.3%. Cox regression analysis demonstrated that factors independently associated with increased infection risk included duration of EVD placement for ≥8 days (HR=2.47 (1.12–5.45); p=0.03), regular sampling (daily sampling (HR=4.73 (1.28–17.42), p=0.02) and alternate day sampling (HR=5.28 (2.25–12.38); p<0.01). There was no association between catheter type or tunnelling distance and ERI.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>In the UK and Ireland, the ERI rate was 9.3% during the study period. The study demonstrated that EVDs left in situ for ≥8 days and those sampled more frequently were associated with a higher risk of infection. Importantly, the study showed no significant difference in ERI risk between different catheter types.</jats:p></jats:sec> | |
dc.format.extent | 120-126 | |
dc.format.medium | Print-Electronic | |
dc.language | en | |
dc.language.iso | eng | |
dc.publisher | BMJ | |
dc.subject | Adolescent | |
dc.subject | Adult | |
dc.subject | Aged | |
dc.subject | Aged, 80 and over | |
dc.subject | Catheter-Related Infections | |
dc.subject | Catheters, Indwelling | |
dc.subject | Cerebral Ventricles | |
dc.subject | Child | |
dc.subject | Child, Preschool | |
dc.subject | Female | |
dc.subject | Humans | |
dc.subject | Infant | |
dc.subject | Infant, Newborn | |
dc.subject | Ireland | |
dc.subject | Male | |
dc.subject | Middle Aged | |
dc.subject | Neurosurgical Procedures | |
dc.subject | Postoperative Complications | |
dc.subject | Proportional Hazards Models | |
dc.subject | Prospective Studies | |
dc.subject | Staphylococcal Infections | |
dc.subject | United Kingdom | |
dc.subject | Ventriculostomy | |
dc.subject | Young Adult | |
dc.title | Prospective, multicentre study of external ventricular drainage-related infections in the UK and Ireland | |
dc.type | journal-article | |
dc.type | Article | |
plymouth.author-url | https://www.ncbi.nlm.nih.gov/pubmed/29070645 | |
plymouth.issue | 2 | |
plymouth.volume | 89 | |
plymouth.publisher-url | http://dx.doi.org/10.1136/jnnp-2017-316415 | |
plymouth.publication-status | Published | |
plymouth.journal | Journal of Neurology, Neurosurgery & Psychiatry | |
dc.identifier.doi | 10.1136/jnnp-2017-316415 | |
plymouth.organisational-group | /Plymouth | |
plymouth.organisational-group | /Plymouth/Faculty of Health | |
plymouth.organisational-group | /Plymouth/Users by role | |
dc.publisher.place | England | |
dcterms.dateAccepted | 2017-10-09 | |
dc.identifier.eissn | 1468-330X | |
dc.rights.embargoperiod | Not known | |
rioxxterms.versionofrecord | 10.1136/jnnp-2017-316415 | |
rioxxterms.licenseref.uri | http://www.rioxx.net/licenses/all-rights-reserved | |
rioxxterms.licenseref.startdate | 2018-02 | |
rioxxterms.type | Journal Article/Review |