Bolt-connected silver-coated external ventricular drains have a lower risk of infection compared with tunnelled antibiotic-impregnated catheters: a pilot study.
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引用次数: 0
Abstract
Purpose: To compare the risk of ventriculostomy-related infection (VRI) according to the type of external ventricular drain (EVD) used: bolt-connected silver-coated EVD (antimicrobial effect) vs. tunnelled antibiotic-impregnated EVD, and determine which catheter is superior. The secondary endpoint is to estimate the infection risk depending on the ventriculostomy duration.
Methods: Prospective single-centre cohort study. All patients who underwent EVD placement between January 2022 and August 2024 were included. Infection was the primary endpoint. Cox regression analysis was used to determine the hazard ratio (HR) depending on the type of catheter, adjusting for possible confounding covariables. Kaplan-Meier curves were used to estimate the cumulative risk of infection.
Results: 90 procedures were analysed. The overall infection rate was 7.8%. A significantly higher infection risk was confirmed when tunnelled antibiotic-impregnated catheters were used compared to bolt-connected silver-coated drains after adjusting by the setting of the placement and duration of ventriculostomy (HR 7.61 [95% CI 1.30-44.38, p=0.024]). Placement of the device in the ICU was also independently associated with a higher risk of infection than in the operating room (HR 8.16 [95% CI 1.17-56.94, p=0.034]). The risk of VRI was 0% by day five, 1.6% by day 10, and 23.5% by day 30.
Conclusions: Bolt-connected silver-coated catheters (antimicrobial coating and skull anchoring) were associated with an 88% lower risk of VRI than subcutaneous tunnelled antibiotic-impregnated catheters. Drain placement in the ICU was also associated with a higher risk of infection. The risk of VRI was 0% by day five and 1.6% by day 10.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
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