1330. Characteristics and Outcomes of External Ventricular Drain Infections

BACKGROUND: External ventricular drain (EVD)-related ventriculitis is a serious complication associated with poor patient outcomes. We aim to: (1) characterize patient-level factors and outcomes of individuals with EVD-related ventriculitis and (2) identify differences by type of infection and indication of EVD-placement. METHODS: This study is a single center, case series of adults hospitalized with a diagnosis of EVD-related ventriculitis between January 2018 to February 2023. EVD-related ventriculitis was defined as having a positive cerebrospinal fluid culture from an EVD consistent with CDC/NHSN criteria for ventriculitis. Several covariates were extracted from patient charts to characterize patient outcomes. Further stratification by type of infection (gram-positive versus gram-negative ventriculitis) and indication (traumatic versus non-traumatic EVD placement) were performed to identify any differences in characteristics between the two groups. RESULTS: Twenty-two patients were identified in the study. The majority of patients were infected with gram-positive bacteria (54.5%) rather than gram-negative bacteria (41%) with 1 case of fungus. The most common indication for EVD placement was trauma (59%) and most were placed at bedside (91%) rather than an operating room (9%). The mean length of stay (LOS) was 42.14 days. (Table 1) There was a statistically significant difference in the CSF to serum glucose ratio between gram-negative and gram-positive infections with gram negative ventriculitis having a lower ratio compared to patients with gram positive ventriculitis (0.23 vs 0.59, p=0.0005). However, LOS, interval from catheterization to infection, and other CSF parameters were similar between the two groups as well as those whose EVDs were placed in the setting of traumatic vs non-traumatic settings. (Table 2 and 3) [Figure: see text] [Figure: see text] Characteristics stratified by trauma vs non-trauma patients [Figure: see text] CONCLUSION: Patients with EVD-related ventriculitis had double the LOS compared to neurosurgical patients without EVD-related ventriculitis reported in the literature. Patients with gram-negative ventriculitis had a lower CSF to serum glucose ratio than those with gram-positive ventriculitis. Otherwise, patient characteristics and outcomes were similar when stratified by type of infection and indication. DISCLOSURES: All Authors: No reported disclosures