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Healthcare-Associated Ventriculitis and Meningitis: A Retrospective Analysis

Background and objective Healthcare-associated ventriculitis and meningitis (HAVM) is frequent in neurocritical patients and associated with significant mortality. Surgery and intracranial devices are usually necessary and may lead to infection. Classical clinical signs and cerebral spinal fluid (CS...

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Autores principales: Coelho, Elisabete, Costa, Laura, Martins, José, Costa, Marina, Oliveira, José E, Maia-Gonçalves, António, Lencastre, Luís
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8617354/
https://www.ncbi.nlm.nih.gov/pubmed/34849306
http://dx.doi.org/10.7759/cureus.19069
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author Coelho, Elisabete
Costa, Laura
Martins, José
Costa, Marina
Oliveira, José E
Maia-Gonçalves, António
Lencastre, Luís
author_facet Coelho, Elisabete
Costa, Laura
Martins, José
Costa, Marina
Oliveira, José E
Maia-Gonçalves, António
Lencastre, Luís
author_sort Coelho, Elisabete
collection PubMed
description Background and objective Healthcare-associated ventriculitis and meningitis (HAVM) is frequent in neurocritical patients and associated with significant mortality. Surgery and intracranial devices are usually necessary and may lead to infection. Classical clinical signs and cerebral spinal fluid (CSF) analysis may be unreliable. The purpose of this study was to characterize the prevalence of HAVM, risk factors, and interventions in the neurocritical population admitted in the ICU. Methods This was a retrospective single-center analysis of all adult neurocritical patients admitted to an ICU during a three-year period. Results A total of 218 neurocritical patients were included. The prevalence of HAVM was 13% and it was found to be associated with mortality. When suspected, it was not possible to exclude HAVM in 30% of the patients. HAVM was significantly associated with surgery, surgical reintervention, and brain devices. Sustained fever was the most frequent clinical sign, and it was significantly associated with unexcluded HAVM. CSF cell count was significantly higher in HAVM, though without microbiological isolation in most of the cases. Conclusion Brain damage, interventions, and devices may significantly alter cerebral homeostasis. Sustained fever is very frequent and may be attributed to several conditions. CSF cell count is useful for the diagnosis of HAVM. HAVM is a clinical challenge in the management of neurocritical patients with important therapeutic and prognostic implications.
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spelling pubmed-86173542021-11-29 Healthcare-Associated Ventriculitis and Meningitis: A Retrospective Analysis Coelho, Elisabete Costa, Laura Martins, José Costa, Marina Oliveira, José E Maia-Gonçalves, António Lencastre, Luís Cureus Infectious Disease Background and objective Healthcare-associated ventriculitis and meningitis (HAVM) is frequent in neurocritical patients and associated with significant mortality. Surgery and intracranial devices are usually necessary and may lead to infection. Classical clinical signs and cerebral spinal fluid (CSF) analysis may be unreliable. The purpose of this study was to characterize the prevalence of HAVM, risk factors, and interventions in the neurocritical population admitted in the ICU. Methods This was a retrospective single-center analysis of all adult neurocritical patients admitted to an ICU during a three-year period. Results A total of 218 neurocritical patients were included. The prevalence of HAVM was 13% and it was found to be associated with mortality. When suspected, it was not possible to exclude HAVM in 30% of the patients. HAVM was significantly associated with surgery, surgical reintervention, and brain devices. Sustained fever was the most frequent clinical sign, and it was significantly associated with unexcluded HAVM. CSF cell count was significantly higher in HAVM, though without microbiological isolation in most of the cases. Conclusion Brain damage, interventions, and devices may significantly alter cerebral homeostasis. Sustained fever is very frequent and may be attributed to several conditions. CSF cell count is useful for the diagnosis of HAVM. HAVM is a clinical challenge in the management of neurocritical patients with important therapeutic and prognostic implications. Cureus 2021-10-27 /pmc/articles/PMC8617354/ /pubmed/34849306 http://dx.doi.org/10.7759/cureus.19069 Text en Copyright © 2021, Coelho et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Infectious Disease
Coelho, Elisabete
Costa, Laura
Martins, José
Costa, Marina
Oliveira, José E
Maia-Gonçalves, António
Lencastre, Luís
Healthcare-Associated Ventriculitis and Meningitis: A Retrospective Analysis
title Healthcare-Associated Ventriculitis and Meningitis: A Retrospective Analysis
title_full Healthcare-Associated Ventriculitis and Meningitis: A Retrospective Analysis
title_fullStr Healthcare-Associated Ventriculitis and Meningitis: A Retrospective Analysis
title_full_unstemmed Healthcare-Associated Ventriculitis and Meningitis: A Retrospective Analysis
title_short Healthcare-Associated Ventriculitis and Meningitis: A Retrospective Analysis
title_sort healthcare-associated ventriculitis and meningitis: a retrospective analysis
topic Infectious Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8617354/
https://www.ncbi.nlm.nih.gov/pubmed/34849306
http://dx.doi.org/10.7759/cureus.19069
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