gms | German Medical Science

61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

Antiseptic silver-repleted external ventricular drains fail to reduce infection rate in catheter associated meningitis

Meeting Abstract

  • Oliver Müller - Klinik für Neurochirurgie, Universitätsklinikum Essen, Deutschland
  • Susanne Jurig - Klinik für Neurochirurgie, Universitätsklinikum Essen, Deutschland
  • Klaus-Peter Stein - Klinik für Neurochirurgie, Universitätsklinikum Essen, Deutschland
  • Beate Schoch - Klinik für Neurochirurgie, Gesundheitszentrum Evangelisches Stift St. Martin Koblenz, Deutschland
  • Ulrich Sure - Klinik für Neurochirurgie, Universitätsklinikum Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1617

DOI: 10.3205/10dgnc090, URN: urn:nbn:de:0183-10dgnc0901

Published: September 16, 2010

© 2010 Müller et al.
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Outline

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Objective: To investigate the potential of external ventricular catheters fabricated with 2% of nano-particles of silver and insoluble silver-nitrates (Silverline®, Fa. Spiegelberg:) to reduce catheter associated meningitis (CAM) compared to conventional polyurethane catheters.

Methods: 272 patients requiring external ventricular drainage (EVD) met the inclusion criterias and were enrolled in this prospective, single-center study authorized by the local research ethics committee. 145 males and 127 females with a mean age of 56 (range 18–93) years at time of surgery were prospectively followed for the occurrence of CAM. CAM was diagnosed by local standard protocol (existence of two of the following criteria: increase of cell countCSF (CCCSF) >100% within 24 hours, clinical signs as fever, meningism, deterioration not due to the underlying disease and/or culture of a causative organism). The use of Silver-catheters or polyurethan catheters was preoperatively randomized for all patients. 129 Silverline®-catheters and 143 Polyurethan catheters were randomized.

Results: Student t-test revealed no difference between the two treatment groups (gender, age, duration of treatment with EVD). Main diagnoses leading to EVD were subarachnoidal hemorrhages due to a ruptured aneurysm (112 cases), non-aneurysmal intracerebral hemorrhage (63 cases) and tumors (56 cases). CAM was diagnosed in 39 patients (14.3%). 24 of the 129 Silverline® catheters (18.6%) and 15 of the Polyurethan catheters (10.5%) lead to CAM. The difference was statistically not significant (p=0.057) despite its strong tendency.

Conclusions: The antiseptic catheters repleted with nano-particles of silver failed grossly to reduce CAM compared to conventional catheters. The rate of CAM in the group of the Silverline® catheters was higher than in the conventional catheter group, though not statistically significant (p=0.057). Therefore, the use of these catheters cannot be recommended for reduction of CAM.