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Published in: Acta Neurochirurgica 3/2011

01-03-2011 | Clinical Article

Reduction in external ventricular drain infection rate. Impact of a minimal handling protocol and antibiotic-impregnated catheters

Authors: Mónica Rivero-Garvía, Javier Márquez-Rivas, Manuel Enrique Jiménez-Mejías, Olaf Neth, Ana Belén Rueda-Torres

Published in: Acta Neurochirurgica | Issue 3/2011

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Abstract

Introduction

Many strategies have been developed with the aim of reducing external ventricular drain-related infections. Antibiotic-impregnated catheters are one of them.

Material and methods

We report 648 cases of external ventricular drain from a total of 534 patients treated at the Virgen del Rocío Hospital between 1995 and 2006. Three subgroups were considered: group 1 included patients treated between 1995 and 2000, as well as a total of 190 external ventricular drains and 59 cases of infection (31.05%); group 2, with patients treated between 2000 and 2004 and managed with a minimal handling protocol, included 210 external ventricular drains and nine cases of infection (4.29%); and group 3, treated between 2004 and 2006, with 248 external ventricular drains and six cases of infection (2.41%). This latter subgroup included patients managed with a minimal handling protocol and antibiotic-impregnated catheters.

Results

Infection rate was 17% when non-antibiotic-impregnated catheters were employed and 2.41% when antibiotic-impregnated catheters were inserted (p < 0.001). This difference was statistically significant before and after the introduction of a minimal handling protocol, with percentages of 5.31% and 3.27%, respectively (p < 0.001; odds ratio 0.08; absolute risk reduction 27.26%). However, no statistically significant difference was observed in infection rate when the impact of a minimal handling protocol was considered: 4.29% when only the protocol was introduced and 2.41% when both the protocol and antibiotic-impregnated catheters were used (p > 0.05).

Conclusion

Minimal handling protocols constitute an essential strategy in the reduction of external ventricular drain-related infections. Besides that, the use of antibiotic-impregnated catheters may reduce infection-related hospital costs.
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Metadata
Title
Reduction in external ventricular drain infection rate. Impact of a minimal handling protocol and antibiotic-impregnated catheters
Authors
Mónica Rivero-Garvía
Javier Márquez-Rivas
Manuel Enrique Jiménez-Mejías
Olaf Neth
Ana Belén Rueda-Torres
Publication date
01-03-2011
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 3/2011
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-010-0905-1

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