caa a22 4500 606214682 CHVBK 20210128101055.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s00701-015-2574-6 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2574-6 Clinical, biological, and microbiological pattern associated with ventriculostomy-related infection: a retrospective longitudinal study [Elektronische Daten] [Roman Mounier, David Lobo, Fabrice Cook, Alexandre Fratani, Arie Attias, Mathieu Martin, Karin Chedevergne, Jean Bardon, Sanaa Tazi, Biba Nebbad, Sébastien Bloc, Benoît Plaud, Gilles Dhonneur] Background: Our aim was to describe the pattern of ventriculostomy-related infection (VRI) development using a dynamic approach. Study design: Retrospective longitudinal study. Methods: We analyzed the files of 449 neurosurgical patients who underwent placement of external ventricular drain (EVD). During the study period, CSF sampling was performed on a daily base setting. VRI was defined as a positive CSF culture resulting in antibiotic treatment. For VRI patients, we arbitrary defined day 0 (D0) as the day antibiotic treatment was started. In these patients, we compared dynamic changes in clinical and biological parameters at four pre-determined time points: (D-4, D-3, D-2, D-1) with those of D0. For all CSF-positive cultures, we compared CSF biochemical markers' evolution pattern between VRI patients and the others, considered as a control cohort. Results: Thirty-two suffered from VRI. Peripheral white blood cell count did not differ between D-4-D0. Median body temperature, CSF cell count, median Glasgow Coma Scale, CSF protein, and glucose concentrations were significantly different between D-4, D-3, D-2, and D0. At D0, 100% of CSF samples yielded organisms in culture. The physician caring for the patient decided to treat VRI based upon positive CSF culture in only 28% (9/32) of cases. In the control cohort, CSF markers' profile trends to normalize, while it worsens in the VRI patients. Conclusions: We showed that clinical symptoms and biological abnormalities of VRI evolved over time. Our data suggest that VRI decision to treat relies upon a bundle of evidence, including dynamic changes in CSF laboratory exams combined with microbiological analysis. Springer-Verlag Wien, 2015 Cerebrospinal fluid nationallicence Cerebrospinal fluid culture nationallicence Diagnosis nationallicence External ventricular drain nationallicence Nosocomial meningitis nationallicence Ventriculostomy-related infection nationallicence Mounier Roman Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut Lobo David Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut Cook Fabrice Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut Fratani Alexandre Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut Attias Arie Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut Martin Mathieu Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut Chedevergne Karin Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut Bardon Jean Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut Tazi Sanaa Department of Neurosurgery, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut Nebbad Biba Department of Microbiology, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut Bloc Sébastien Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut Plaud Benoît Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut Dhonneur Gilles Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut Acta Neurochirurgica Springer Vienna 157/12(2015-12-01), 2209-2217 0001-6268 157:12<2209 2015 157 701 https://doi.org/10.1007/s00701-015-2574-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2574-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mounier Roman Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut NATIONALLICENCE 700 1- Lobo David Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut NATIONALLICENCE 700 1- Cook Fabrice Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut NATIONALLICENCE 700 1- Fratani Alexandre Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut NATIONALLICENCE 700 1- Attias Arie Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut NATIONALLICENCE 700 1- Martin Mathieu Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut NATIONALLICENCE 700 1- Chedevergne Karin Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut NATIONALLICENCE 700 1- Bardon Jean Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut NATIONALLICENCE 700 1- Tazi Sanaa Department of Neurosurgery, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut NATIONALLICENCE 700 1- Nebbad Biba Department of Microbiology, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut NATIONALLICENCE 700 1- Bloc Sébastien Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut NATIONALLICENCE 700 1- Plaud Benoît Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut NATIONALLICENCE 700 1- Dhonneur Gilles Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris XII School of Medicine, 94000, Créteil, France aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/12(2015-12-01), 2209-2217 0001-6268 157:12<2209 2015 157 701