Skip to main content
Erschienen in: Current Infectious Disease Reports 11/2016

01.11.2016 | Central Nervous System Infections (K Bloch, Section Editor)

Central Nervous System Device Infections

verfasst von: Rodrigo Hasbun

Erschienen in: Current Infectious Disease Reports | Ausgabe 11/2016

Einloggen, um Zugang zu erhalten

Abstract

Nosocomial meningitis can occur in association with central nervous system (CNS) devices such as cerebrospinal shunts or drains, intrathecal pumps, and deep brain stimulators and carry substantial morbidity and mortality. Diagnosing and treating these infections may be challenging to physicians as cerebrospinal fluid cultures may be negative due to previous antibiotic therapy and cerebrospinal abnormalities may be secondary to the primary neurosurgical issue that prompted the placement of the CNS device (e.g., “chemical meningitis” due to intracranial hemorrhage). Besides antibiotic therapy given intravenously and sometimes intrathecally, removal of the device with repeat cultures prior to re-implantation is key in achieving successful outcomes.
Literatur
1.•
Zurück zum Zitat van de Beek D, Drake JM, Tunkel AR. Nosocomial bacterial meningitis. N Engl J Med. 2010;362(2):146–54. An excellent review of the different causes of nosocomial meningitis.CrossRefPubMed van de Beek D, Drake JM, Tunkel AR. Nosocomial bacterial meningitis. N Engl J Med. 2010;362(2):146–54. An excellent review of the different causes of nosocomial meningitis.CrossRefPubMed
2.
Zurück zum Zitat Dery M, Hasbun R. Changing epidemiology of bacterial meningitis. Curr Infect Dis Rep. 2007;9(4):301–7.CrossRefPubMed Dery M, Hasbun R. Changing epidemiology of bacterial meningitis. Curr Infect Dis Rep. 2007;9(4):301–7.CrossRefPubMed
3.••
Zurück zum Zitat Castelblanco RL, Lee M, Hasbun R. Epidemiology of bacterial meningitis in the USA from 1997 to 2010: a population-based observational study. Lancet Infect Dis. 2014;14(9):813–9. A large population-based observational study describing the changing epidemiology of the most common community and nosocomial acquired bacterial meningitis pathogens from 1997–2010.CrossRefPubMed Castelblanco RL, Lee M, Hasbun R. Epidemiology of bacterial meningitis in the USA from 1997 to 2010: a population-based observational study. Lancet Infect Dis. 2014;14(9):813–9. A large population-based observational study describing the changing epidemiology of the most common community and nosocomial acquired bacterial meningitis pathogens from 1997–2010.CrossRefPubMed
4.
Zurück zum Zitat Edwards R, Drake J. Cerebrospinal fluid devices. In: Winn HR, editor. Youman’s Neurological Surgery, 6th ed 2011. 2029–34. Edwards R, Drake J. Cerebrospinal fluid devices. In: Winn HR, editor. Youman’s Neurological Surgery, 6th ed 2011. 2029–34.
5.•
Zurück zum Zitat Dawod J, Tager A, Darouiche RO, Mohajer MA. Prevention and management of internal cerebrospinal fluid shunt infections. J Hosp Infect. 2016;93(4):323–8. A thorough recent review of the prevention and management of cerebrospinal fluid shunt infections.CrossRefPubMed Dawod J, Tager A, Darouiche RO, Mohajer MA. Prevention and management of internal cerebrospinal fluid shunt infections. J Hosp Infect. 2016;93(4):323–8. A thorough recent review of the prevention and management of cerebrospinal fluid shunt infections.CrossRefPubMed
6.
Zurück zum Zitat Ramanan M, Lipman J, Shorr A, Shankar A. A meta-analysis of ventriculostomy-associated cerebrospinal fluid infections. BMC Infect Dis. 2015;15:3.CrossRefPubMedPubMedCentral Ramanan M, Lipman J, Shorr A, Shankar A. A meta-analysis of ventriculostomy-associated cerebrospinal fluid infections. BMC Infect Dis. 2015;15:3.CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Motta F, Antonello CE. Analysis of complications in 430 consecutive pediatric patients treated with intrathecal baclofen therapy: 14-year experience. J Neurosurg Pediatr. 2014;13(3):301–6.CrossRefPubMed Motta F, Antonello CE. Analysis of complications in 430 consecutive pediatric patients treated with intrathecal baclofen therapy: 14-year experience. J Neurosurg Pediatr. 2014;13(3):301–6.CrossRefPubMed
8.
Zurück zum Zitat Fjelstad AB, Hommelstad J, Sorteberg A. Infections related to intrathecal baclofen therapy in children and adults: frequency and risk factors. J Neurosurg Pediatr. 2009;4(5):487–93.CrossRefPubMed Fjelstad AB, Hommelstad J, Sorteberg A. Infections related to intrathecal baclofen therapy in children and adults: frequency and risk factors. J Neurosurg Pediatr. 2009;4(5):487–93.CrossRefPubMed
9.
Zurück zum Zitat Vender JR, Hester S, Waller JL, Rekito A, Lee MR. Identification and management of intrathecal baclofen pump complications: a comparison of pediatric and adult patients. J Neurosurg. 2006;104(1 Suppl):9–15.PubMed Vender JR, Hester S, Waller JL, Rekito A, Lee MR. Identification and management of intrathecal baclofen pump complications: a comparison of pediatric and adult patients. J Neurosurg. 2006;104(1 Suppl):9–15.PubMed
10.
Zurück zum Zitat Ghosh D, Mainali G, Khera J, Luciano M. Complications of intrathecal baclofen pumps in children: experience from a tertiary care center. Pediatr Neurosurg. 2013;49(3):138–44.CrossRefPubMed Ghosh D, Mainali G, Khera J, Luciano M. Complications of intrathecal baclofen pumps in children: experience from a tertiary care center. Pediatr Neurosurg. 2013;49(3):138–44.CrossRefPubMed
11.
Zurück zum Zitat Fily F, Haegelen C, Tattevin P, et al. Deep brain stimulation hardware-related infections: a report of 12 cases and review of the literature. Clin Infect Dis. 2011;52(8):1020–3.CrossRefPubMed Fily F, Haegelen C, Tattevin P, et al. Deep brain stimulation hardware-related infections: a report of 12 cases and review of the literature. Clin Infect Dis. 2011;52(8):1020–3.CrossRefPubMed
12.
Zurück zum Zitat Bergey GK, Morrell MJ, Mizrahi EM, et al. Long-term treatment with responsive brain stimulation in adults with refractory partial seizures. Neurology. 2015;84(8):810–7.CrossRefPubMedPubMedCentral Bergey GK, Morrell MJ, Mizrahi EM, et al. Long-term treatment with responsive brain stimulation in adults with refractory partial seizures. Neurology. 2015;84(8):810–7.CrossRefPubMedPubMedCentral
14.•
Zurück zum Zitat Srihawan C, Lopez Castelblanco R, Salazar L, Wootton SH, Aguilera E, Ostrosky-Zeichner L, et al. Clinical characterstics and predictors of adverse outcomes in adult and pediatric patients with healthcare-associated ventriculitis and meningitis. Open Forum Infect Dis. 2016; 3(2). A study of 215 adults and children with nosocomial meningitis using the new 2015 CDC definition describing the diagnostic challenges and the high rates of adverse clinical outcomes. Srihawan C, Lopez Castelblanco R, Salazar L, Wootton SH, Aguilera E, Ostrosky-Zeichner L, et al. Clinical characterstics and predictors of adverse outcomes in adult and pediatric patients with healthcare-associated ventriculitis and meningitis. Open Forum Infect Dis. 2016; 3(2). A study of 215 adults and children with nosocomial meningitis using the new 2015 CDC definition describing the diagnostic challenges and the high rates of adverse clinical outcomes.
15.
Zurück zum Zitat Pfausler B, Beer R, Engelhardt K, Kemmler G, Mohsenipour I, Schmutzhard E. Cell index—a new parameter for the early diagnosis of ventriculostomy (external ventricular drainage)-related ventriculitis in patients with intraventricular hemorrhage? Acta Neurochir. 2004;146(5):477–81.CrossRefPubMed Pfausler B, Beer R, Engelhardt K, Kemmler G, Mohsenipour I, Schmutzhard E. Cell index—a new parameter for the early diagnosis of ventriculostomy (external ventricular drainage)-related ventriculitis in patients with intraventricular hemorrhage? Acta Neurochir. 2004;146(5):477–81.CrossRefPubMed
16.
Zurück zum Zitat Walti LN, Conen A, Coward J, Jost GF, Trampuz AJ. Characteristics of infections associated with external ventricular drains of cerebrospinal fluid. J Infect. 2013;66:424–31.CrossRefPubMed Walti LN, Conen A, Coward J, Jost GF, Trampuz AJ. Characteristics of infections associated with external ventricular drains of cerebrospinal fluid. J Infect. 2013;66:424–31.CrossRefPubMed
17.
Zurück zum Zitat Maskin LP, Capparelli F, Mora A, et al. Cerebrospinal fluid lactate in post-neurosurgical bacterial meningitis diagnosis. Clin Neurol Neurosurg. 2013;115(9):1820–5.CrossRefPubMed Maskin LP, Capparelli F, Mora A, et al. Cerebrospinal fluid lactate in post-neurosurgical bacterial meningitis diagnosis. Clin Neurol Neurosurg. 2013;115(9):1820–5.CrossRefPubMed
18.
Zurück zum Zitat Li Y, Zhang G, Ma R, et al. The diagnostic value of cerebrospinal fluids procalcitonin and lactate for the differential diagnosis of post-neurosurgical bacterial meningitis and aseptic meningitis. Clin Biochem. 2015;48(1–2):50–4.CrossRefPubMed Li Y, Zhang G, Ma R, et al. The diagnostic value of cerebrospinal fluids procalcitonin and lactate for the differential diagnosis of post-neurosurgical bacterial meningitis and aseptic meningitis. Clin Biochem. 2015;48(1–2):50–4.CrossRefPubMed
19.•
Zurück zum Zitat Deutch S, Dahlberg D, Hedegaard J, Schmidt MB, Moller JK, Ostergaard L. Diagnosis of ventricular drainage-related bacterial meningitis by broad-range real-time polymerase chain reaction. Neurosurgery. 2007; 61(2): 306–11; discussion 11–2. A small study exploring the role of broad-range polymerase chain reaction in the diagnosis of nosocomial meningitis. Deutch S, Dahlberg D, Hedegaard J, Schmidt MB, Moller JK, Ostergaard L. Diagnosis of ventricular drainage-related bacterial meningitis by broad-range real-time polymerase chain reaction. Neurosurgery. 2007; 61(2): 306–11; discussion 11–2. A small study exploring the role of broad-range polymerase chain reaction in the diagnosis of nosocomial meningitis.
20.
Zurück zum Zitat Yilmaz A, Dalgic N, Musluman M, Sancar M, Colak I, Aydin Y. Linezolid treatment of shunt-related cerebrospinal fluid infections in children. J Neurosurg Pediatr. 2010;5(5):443–8.CrossRefPubMed Yilmaz A, Dalgic N, Musluman M, Sancar M, Colak I, Aydin Y. Linezolid treatment of shunt-related cerebrospinal fluid infections in children. J Neurosurg Pediatr. 2010;5(5):443–8.CrossRefPubMed
21.
Zurück zum Zitat Kullar R, Chin JN, Edwards DJ, Parker D, Coplin WM, Rybak MJ. Pharmacokinetics of single-dose daptomycin in patients with suspected or confirmed neurological infections. Antimicrob Agents Chemother. 2011;55(7):3505–9.CrossRefPubMedPubMedCentral Kullar R, Chin JN, Edwards DJ, Parker D, Coplin WM, Rybak MJ. Pharmacokinetics of single-dose daptomycin in patients with suspected or confirmed neurological infections. Antimicrob Agents Chemother. 2011;55(7):3505–9.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Lozier AP, Sciacca RR, Romagnoli MF, Connolly Jr ES. Ventriculostomy-related infections: a critical review of the literature. Neurosurgery. 2008;62:688–700.CrossRefPubMed Lozier AP, Sciacca RR, Romagnoli MF, Connolly Jr ES. Ventriculostomy-related infections: a critical review of the literature. Neurosurgery. 2008;62:688–700.CrossRefPubMed
23.
Zurück zum Zitat Pappas PG, Kaufman CA, Andes DR, Clancy CJ, Marr KA. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2015. Pappas PG, Kaufman CA, Andes DR, Clancy CJ, Marr KA. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2015.
24.••
Zurück zum Zitat Wilkie MD, Hanson MF, Statham PF, Brennan PM. Infections of cerebrospinal fluid diversion devices in adults: the role of intraventricular antimicrobial therapy. J Infect. 2013;66(3):239–46. An excellent review of the available data on intraventricular antimicrobial therapy.CrossRefPubMed Wilkie MD, Hanson MF, Statham PF, Brennan PM. Infections of cerebrospinal fluid diversion devices in adults: the role of intraventricular antimicrobial therapy. J Infect. 2013;66(3):239–46. An excellent review of the available data on intraventricular antimicrobial therapy.CrossRefPubMed
25.
Zurück zum Zitat Ng K, Mabasa VH, Chow I, Ensom MH. Systematic review of efficacy, pharmacokinetics, and administration of intraventricular vancomycin in adults. Neurocrit Care. 2014;20(1):158–71.CrossRefPubMed Ng K, Mabasa VH, Chow I, Ensom MH. Systematic review of efficacy, pharmacokinetics, and administration of intraventricular vancomycin in adults. Neurocrit Care. 2014;20(1):158–71.CrossRefPubMed
26.
Zurück zum Zitat Karaiskos I, Galani L, Baziaka F, Giamarellou H. Intraventricular and intrathecal colistin as the last therapeutic resort for the treatment of multi-drug resistant and extensively drug-resistant Acinetobacter baumannii ventriculitis and meningitis: a literature review. Int J Antimicrob Agents. 2013;41(6):499–508.CrossRefPubMed Karaiskos I, Galani L, Baziaka F, Giamarellou H. Intraventricular and intrathecal colistin as the last therapeutic resort for the treatment of multi-drug resistant and extensively drug-resistant Acinetobacter baumannii ventriculitis and meningitis: a literature review. Int J Antimicrob Agents. 2013;41(6):499–508.CrossRefPubMed
27.
Zurück zum Zitat Kim HI, Kim SW, Park GY, Kwon EG, Kim HH, et al. The cause and treatment outcomes of 91 patients with adult nosocomial meningitis. Korean J Intern Med. 2012;27(2):171–9.CrossRefPubMedPubMedCentral Kim HI, Kim SW, Park GY, Kwon EG, Kim HH, et al. The cause and treatment outcomes of 91 patients with adult nosocomial meningitis. Korean J Intern Med. 2012;27(2):171–9.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Kestle JR, Riva-Cambrin J, Wellons 3rd JC, et al. A standardized protocol to reduce cerebrospinal fluid shunt infection: the Hydrocephalus Clinical Research Network Quality Improvement Initiative. J Neurosurg Pediatr. 2011;8(1):22–9.CrossRefPubMedPubMedCentral Kestle JR, Riva-Cambrin J, Wellons 3rd JC, et al. A standardized protocol to reduce cerebrospinal fluid shunt infection: the Hydrocephalus Clinical Research Network Quality Improvement Initiative. J Neurosurg Pediatr. 2011;8(1):22–9.CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat Pirotte BJ, Lubansu A, Bruneau M, et al. Sterile surgical technique for shunt placement reduces the shunt infection rate in children: preliminary analysis of a prospective protocol in 115 consecutive procedures. Childs Nerv Syst. 2007;23:1251–61.CrossRefPubMed Pirotte BJ, Lubansu A, Bruneau M, et al. Sterile surgical technique for shunt placement reduces the shunt infection rate in children: preliminary analysis of a prospective protocol in 115 consecutive procedures. Childs Nerv Syst. 2007;23:1251–61.CrossRefPubMed
30.
Zurück zum Zitat Hommelstad J, Madso A, Eide PK. Significant reduction of shunt infection rate in children below 1 year of age after implementation of a perioperative protocol. Acta Neurochir (Wien). 2013;155:523–31.CrossRef Hommelstad J, Madso A, Eide PK. Significant reduction of shunt infection rate in children below 1 year of age after implementation of a perioperative protocol. Acta Neurochir (Wien). 2013;155:523–31.CrossRef
31.
Zurück zum Zitat Choksey MS, Malik IA. Zero tolerance to shunt infections: can it be achieved? J Neurol Neurosurg Psychiatry. 2004;75:87–91.PubMedPubMedCentral Choksey MS, Malik IA. Zero tolerance to shunt infections: can it be achieved? J Neurol Neurosurg Psychiatry. 2004;75:87–91.PubMedPubMedCentral
32.••
Zurück zum Zitat Sonabend AM, Korenfeld Y, Crisman C, Badjatia N, Mayer SA, Connolly Jr ES. Prevention of ventriculostomy-related infections with prophylactic antibiotics and antibiotic-coated external ventricular drains: a systematic review. Neurosurgery. 2011;68(4):996–1005. A systematic review of the available literature evaluating the efficacy of prophylactic antibiotics and antibiotic impregnated ventricular drains in preventing infection.PubMed Sonabend AM, Korenfeld Y, Crisman C, Badjatia N, Mayer SA, Connolly Jr ES. Prevention of ventriculostomy-related infections with prophylactic antibiotics and antibiotic-coated external ventricular drains: a systematic review. Neurosurgery. 2011;68(4):996–1005. A systematic review of the available literature evaluating the efficacy of prophylactic antibiotics and antibiotic impregnated ventricular drains in preventing infection.PubMed
33.
Zurück zum Zitat Ratilal B, Costa J, Sampaio C. Antibiotic prophylaxis for surgical introduction of intracranial ventricular shunts: a systematic review. J Neurosurg Pediatr. 2008;1(1):48–56.CrossRefPubMed Ratilal B, Costa J, Sampaio C. Antibiotic prophylaxis for surgical introduction of intracranial ventricular shunts: a systematic review. J Neurosurg Pediatr. 2008;1(1):48–56.CrossRefPubMed
34.
Zurück zum Zitat Thomas R, Lee S, Patole S, Rao S. Antibiotic-impregnated catheters for the prevention of CSF shunt infections: a systematic review and meta-analysis. Br J Neurosurg. 2012;26(2):175–84.CrossRefPubMed Thomas R, Lee S, Patole S, Rao S. Antibiotic-impregnated catheters for the prevention of CSF shunt infections: a systematic review and meta-analysis. Br J Neurosurg. 2012;26(2):175–84.CrossRefPubMed
35.
Zurück zum Zitat Attenello FJ, Garces-Ambrossi GL, Zaidi HA, Sciubba DM, Jallo GI. Hospital costs associated with shunt infections in patients receiving antibiotic-impregnated shunt catheters versus standard shunt catheters. Neurosurgery. 2010;66(2):284–9. discussion 9.CrossRefPubMed Attenello FJ, Garces-Ambrossi GL, Zaidi HA, Sciubba DM, Jallo GI. Hospital costs associated with shunt infections in patients receiving antibiotic-impregnated shunt catheters versus standard shunt catheters. Neurosurgery. 2010;66(2):284–9. discussion 9.CrossRefPubMed
Metadaten
Titel
Central Nervous System Device Infections
verfasst von
Rodrigo Hasbun
Publikationsdatum
01.11.2016
Verlag
Springer US
Erschienen in
Current Infectious Disease Reports / Ausgabe 11/2016
Print ISSN: 1523-3847
Elektronische ISSN: 1534-3146
DOI
https://doi.org/10.1007/s11908-016-0541-x

Weitere Artikel der Ausgabe 11/2016

Current Infectious Disease Reports 11/2016 Zur Ausgabe

Central Nervous System Infections (K Bloch, Section Editor)

Human Rabies: a 2016 Update

Central Nervous System Infections (K Bloch, Section Editor)

Ocular Syphilis: a Clinical Review

Central Nervous System Infections (K Bloch, Section Editor)

Laboratory Diagnosis of Central Nervous System Infection

Central Nervous System Infections (K Bloch, Section Editor)

Progressive Multifocal Leukoencephalopathy in HIV-Uninfected Individuals

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.