Clinical and Laboratory Characteristics for the Diagnosis of Bacterial Ventriculitis After Aneurysmal Subarachnoid Hemorrhage

J Hoogmoed, D van de Beek, B A Coert, J Horn, W P Vandertop, D Verbaan

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: The diagnosis of nosocomial bacterial ventriculitis in patients with subarachnoid hemorrhage (SAH) can be challenging.

METHODS: We performed a retrospective study on the diagnostic accuracy of clinical and laboratory characteristics for the diagnosis of bacterial ventriculitis in 209 consecutive patients with an aneurysmal SAH admitted in a tertiary referral center from 2008 to 2010. Diagnostic value of clinical characteristics and inflammatory indexes in CSF and blood were determined for three diagnostic categories: (1) no suspicion for bacterial ventriculitis; (2) clinical suspicion for bacterial ventriculitis, defined as initiation of empirical antibiotic treatment for ventriculitis, but negative CSF cultures; and (3) CSF culture-positive bacterial ventriculitis.

RESULTS: Empirical antibiotics for suspected ventriculitis was initiated in 48 of 209 (23 %) patients. CSF cultures were positive in 11 (5 %) patients. Within the group of suspected ventriculitis, only longer duration of CSF drainage and lower CSF red blood cell counts predicted for culture positivity. None of the other clinical features or inflammatory indexes in CSF and blood were associated with culture-proven bacterial ventriculitis.

CONCLUSIONS: Nosocomial bacterial ventriculitis in patients with aneurysmal SAH is often suspected but confirmed by culture in a minority of cases. Improvement of diagnostics for nosocomial bacterial ventriculitis in patients with aneurysmal SAH is needed.

Original languageEnglish
Pages (from-to)362-370
Number of pages9
JournalNeurocritical care
Volume26
Issue number3
DOIs
Publication statusPublished - Jun 2017

Cite this

Hoogmoed, J ; van de Beek, D ; Coert, B A ; Horn, J ; Vandertop, W P ; Verbaan, D. / Clinical and Laboratory Characteristics for the Diagnosis of Bacterial Ventriculitis After Aneurysmal Subarachnoid Hemorrhage. In: Neurocritical care. 2017 ; Vol. 26, No. 3. pp. 362-370.
@article{537469363d4e482c8a71532846e71fd9,
title = "Clinical and Laboratory Characteristics for the Diagnosis of Bacterial Ventriculitis After Aneurysmal Subarachnoid Hemorrhage",
abstract = "BACKGROUND: The diagnosis of nosocomial bacterial ventriculitis in patients with subarachnoid hemorrhage (SAH) can be challenging.METHODS: We performed a retrospective study on the diagnostic accuracy of clinical and laboratory characteristics for the diagnosis of bacterial ventriculitis in 209 consecutive patients with an aneurysmal SAH admitted in a tertiary referral center from 2008 to 2010. Diagnostic value of clinical characteristics and inflammatory indexes in CSF and blood were determined for three diagnostic categories: (1) no suspicion for bacterial ventriculitis; (2) clinical suspicion for bacterial ventriculitis, defined as initiation of empirical antibiotic treatment for ventriculitis, but negative CSF cultures; and (3) CSF culture-positive bacterial ventriculitis.RESULTS: Empirical antibiotics for suspected ventriculitis was initiated in 48 of 209 (23 {\%}) patients. CSF cultures were positive in 11 (5 {\%}) patients. Within the group of suspected ventriculitis, only longer duration of CSF drainage and lower CSF red blood cell counts predicted for culture positivity. None of the other clinical features or inflammatory indexes in CSF and blood were associated with culture-proven bacterial ventriculitis.CONCLUSIONS: Nosocomial bacterial ventriculitis in patients with aneurysmal SAH is often suspected but confirmed by culture in a minority of cases. Improvement of diagnostics for nosocomial bacterial ventriculitis in patients with aneurysmal SAH is needed.",
keywords = "Anti-Bacterial Agents/therapeutic use, Central Nervous System Bacterial Infections/cerebrospinal fluid, Cerebral Ventriculitis/cerebrospinal fluid, Cerebrospinal Fluid Shunts/adverse effects, Cross Infection/cerebrospinal fluid, Female, Humans, Intracranial Aneurysm/complications, Male, Middle Aged, Retrospective Studies, Subarachnoid Hemorrhage/surgery",
author = "J Hoogmoed and {van de Beek}, D and Coert, {B A} and J Horn and Vandertop, {W P} and D Verbaan",
year = "2017",
month = "6",
doi = "10.1007/s12028-016-0345-8",
language = "English",
volume = "26",
pages = "362--370",
journal = "Neurocritical care",
issn = "1541-6933",
publisher = "Humana Press",
number = "3",

}

Clinical and Laboratory Characteristics for the Diagnosis of Bacterial Ventriculitis After Aneurysmal Subarachnoid Hemorrhage. / Hoogmoed, J; van de Beek, D; Coert, B A; Horn, J; Vandertop, W P; Verbaan, D.

In: Neurocritical care, Vol. 26, No. 3, 06.2017, p. 362-370.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Clinical and Laboratory Characteristics for the Diagnosis of Bacterial Ventriculitis After Aneurysmal Subarachnoid Hemorrhage

AU - Hoogmoed, J

AU - van de Beek, D

AU - Coert, B A

AU - Horn, J

AU - Vandertop, W P

AU - Verbaan, D

PY - 2017/6

Y1 - 2017/6

N2 - BACKGROUND: The diagnosis of nosocomial bacterial ventriculitis in patients with subarachnoid hemorrhage (SAH) can be challenging.METHODS: We performed a retrospective study on the diagnostic accuracy of clinical and laboratory characteristics for the diagnosis of bacterial ventriculitis in 209 consecutive patients with an aneurysmal SAH admitted in a tertiary referral center from 2008 to 2010. Diagnostic value of clinical characteristics and inflammatory indexes in CSF and blood were determined for three diagnostic categories: (1) no suspicion for bacterial ventriculitis; (2) clinical suspicion for bacterial ventriculitis, defined as initiation of empirical antibiotic treatment for ventriculitis, but negative CSF cultures; and (3) CSF culture-positive bacterial ventriculitis.RESULTS: Empirical antibiotics for suspected ventriculitis was initiated in 48 of 209 (23 %) patients. CSF cultures were positive in 11 (5 %) patients. Within the group of suspected ventriculitis, only longer duration of CSF drainage and lower CSF red blood cell counts predicted for culture positivity. None of the other clinical features or inflammatory indexes in CSF and blood were associated with culture-proven bacterial ventriculitis.CONCLUSIONS: Nosocomial bacterial ventriculitis in patients with aneurysmal SAH is often suspected but confirmed by culture in a minority of cases. Improvement of diagnostics for nosocomial bacterial ventriculitis in patients with aneurysmal SAH is needed.

AB - BACKGROUND: The diagnosis of nosocomial bacterial ventriculitis in patients with subarachnoid hemorrhage (SAH) can be challenging.METHODS: We performed a retrospective study on the diagnostic accuracy of clinical and laboratory characteristics for the diagnosis of bacterial ventriculitis in 209 consecutive patients with an aneurysmal SAH admitted in a tertiary referral center from 2008 to 2010. Diagnostic value of clinical characteristics and inflammatory indexes in CSF and blood were determined for three diagnostic categories: (1) no suspicion for bacterial ventriculitis; (2) clinical suspicion for bacterial ventriculitis, defined as initiation of empirical antibiotic treatment for ventriculitis, but negative CSF cultures; and (3) CSF culture-positive bacterial ventriculitis.RESULTS: Empirical antibiotics for suspected ventriculitis was initiated in 48 of 209 (23 %) patients. CSF cultures were positive in 11 (5 %) patients. Within the group of suspected ventriculitis, only longer duration of CSF drainage and lower CSF red blood cell counts predicted for culture positivity. None of the other clinical features or inflammatory indexes in CSF and blood were associated with culture-proven bacterial ventriculitis.CONCLUSIONS: Nosocomial bacterial ventriculitis in patients with aneurysmal SAH is often suspected but confirmed by culture in a minority of cases. Improvement of diagnostics for nosocomial bacterial ventriculitis in patients with aneurysmal SAH is needed.

KW - Anti-Bacterial Agents/therapeutic use

KW - Central Nervous System Bacterial Infections/cerebrospinal fluid

KW - Cerebral Ventriculitis/cerebrospinal fluid

KW - Cerebrospinal Fluid Shunts/adverse effects

KW - Cross Infection/cerebrospinal fluid

KW - Female

KW - Humans

KW - Intracranial Aneurysm/complications

KW - Male

KW - Middle Aged

KW - Retrospective Studies

KW - Subarachnoid Hemorrhage/surgery

U2 - 10.1007/s12028-016-0345-8

DO - 10.1007/s12028-016-0345-8

M3 - Article

VL - 26

SP - 362

EP - 370

JO - Neurocritical care

JF - Neurocritical care

SN - 1541-6933

IS - 3

ER -