gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

Catheter-associated meningitis in paediatric patients after brain surgery – incidence and risk factors

Katheter-assoziierte Meningitis bei pädiatrischen Patienten nach Hirnoperation – Inzidenz und Risikofaktoren

Meeting Abstract

  • presenting/speaker Mehdi Chihi - Universitätsklinikum Essen, Neurochirurgie, Essen, Deutschland
  • Oliver Gembruch - Universitätsklinikum Essen, Neurochirurgie, Essen, Deutschland
  • Yahya Ahmadipour - Universitätsklinikum Essen, Neurochirurgie, Essen, Deutschland
  • Philipp Dammann - Universitätsklinikum Essen, Neurochirurgie, Essen, Deutschland
  • Ramazan Jabbarli - Universitätsklinikum Essen, Neurochirurgie, Essen, Deutschland
  • Nicolai El Hindy - Katholisches Klinikum Lünen/Werne GmbH, Wirbelsäulenchirurgie, Werne, Deutschland
  • Ulrich Sure - Universitätsklinikum Essen, Neurochirurgie, Essen, Deutschland
  • Oliver Müller - Universitätsklinikum Essen, Neurochirurgie, Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocP041

doi: 10.3205/19dgnc379, urn:nbn:de:0183-19dgnc3793

Published: May 8, 2019

© 2019 Chihi et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: External ventricular drainage (EVD) is frequently used in pediatric brain surgery. During the externalization of cerebrospinal fluid (CSF), catheter-associated meningitis (CAM) remains a major issue. This study aimed to evaluate the incidence of CAM in a pediatric population and to elucidate major risk factors.

Methods: We analyzed retrospectively the medical and radiological records of 205 pediatric patients receiving 251 EVDs between January 2008 and December 2017. Inclusion criteria were: age ≤18 years, patients undergoing brain surgery and EVD insertion within 24 hours prior/after surgery. Patients who had a central nervous system (CNS) infection at the time of EVD insertion were excluded from the study. Infections were considered drain-related if at the time of the CNS infection, the drain had been in place for at least 48 hours.

Results: Of 205 patients, a total of 118 patients receiving 130 EVDs insertions were included for study purposes. The incidence of CAM was 17.8% (21/118). Mean time-to-infection was 5 days ±4.2. CAM prolonged the period of drainage in 61.9% of the cases (13/21). Postoperative CSF leakage along the catheter was statistically associated with CAM. Prolonged drainage (>7 days) as well as an extended ICU abidance were statistically associated, and each variable showed a statistically significant association with CAM.

Conclusion: pediatric patients, the first postoperative days on the ICU remain challenging and represent a critical period for the EVD, where CSF leakage along the EVD tunnel is likely to happen, possibly leading to a CAM. Measures to prevent CSF leakage and to reduce the incidence of CAM are needed especially in the pediatric population that is more prone to infections than adults.