Immediate diagnosis of ventriculits: evaluation of parameters independent of microbiological culture

Boeer, Klas; Vogelsang, Heinz; Deufel, Thomas; Pfister, W.; Kiehntopf, Michael

doi:10.1007/s00701-011-1079-1

Cited by 12 publications

(7 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pooled results showed an elevated leukocyte count in 4 studies including 78 patients with-and 637 patients without an external ventricular catheter-associated infection [23,[33][34][35]. For an elevated C-reactive protein, reported sensitivities range from 79% to 100%, but specificity is low, ranging from 20% to 64% [23,36,37].…”

Section: Blood Measuresmentioning

confidence: 99%

Bacterial external ventricular catheter-associated infection

Dorresteijn

Brouwer

Jellema

et al. 2020

Expert Review of Anti-infective Therapy

View full text Add to dashboard Cite

Introduction: 9-20% of the patients with an external ventricular drain develop a catheter-associated infection.Areas covered: This review summarizes the diagnostic process and management of bacterial external ventricular catheter-associated infection. Expert commentary: Current literature shows that no single CSF-, blood-or microbiological measure can be used to differentiate between an infection and sterile inflammation. The gold standard of diagnosis remains CSF culture. Empiric antimicrobial treatment consists of vancomycin combined with an anti-pseudomonal β-lactam. The increase in multi-drug resistant Gram-negative bacteria is an emerging problem in the treatment. Preventive measures and antibiotic-impregnated drains have shown to contribute to reducing incidence of external ventricular drain-associated infections.

show abstract

Section: Blood Measuresmentioning

confidence: 99%

Bacterial external ventricular catheter-associated infection

Dorresteijn

Brouwer

Jellema

et al. 2020

Expert Review of Anti-infective Therapy

View full text Add to dashboard Cite

show abstract

“…[52] In bacterial meningitis, all patients had highly increased IL-6, after 14 days 3/9 emained the cytokine excessing the normal value. [52] bacterial neuroinfection -elevated IL-1 connects with unfavourable prognosis [27]; IL-1α is better patient condition marker at the onset of the disease [28] -IL-1Ra is a good indicator of response to antibiotics in neuroborreliosis -mean IL-6 value statistically higher than in viral [33] -IL-8 concentration higher than in viral [33,35] -TNF-α is increased in most bacterial meningitis, no association in viral cases [33,34,47,48] viral neuroinfection and aseptic CNS inflammation)…”

Section: Disorder Cytokine Pattern Cytokine Dynamicsmentioning

confidence: 99%

“…According to assessments on patients with neonatal hypoxic-ischaemic encephalopathy, IL-1β is the best predictive value for neurological sequelae in the age of 6-and 12-months, with the highest ratio between concentration in serum and CSF [25,26]. IL-1β is less related to antibiotic treatment than TNF-α, making the first a better marker of the marker of the patient's condition at the onset of the disease [27]. In CNS infections an IL-1β measurement is a useful tool in distinguishing two most frequent aetiologies -bacterial and viral.…”

Section: Introductionmentioning

confidence: 99%

Cytokine detection in cerebrospinal fluid in central nervous system diseases in children

Lubarski¹,

Mania²,

Mazur‐Melewska³

et al. 2021

Child Neurology

View full text Add to dashboard Cite

Cytokine activation and inflammatory process is a result of complex interaction in the pathogenesis of various central nervous system disorders (CNS). Both proinflammatory and anti- -inflammatory cytokines are produced during immune response. Cytokines measurement in the cerebrospinal fluid (CSF) may be used as an additional tool in patients assessment. In the state of CNS infection, IL-1, IL-6, IL-8, IL-10 and TNF-α levels are typically elevated. Cytokine level alterations after antibiotic therapy are not fully elucidated. Some cytokines, like IL-6, are not only an inflammatory parameter, being elevated in patients with subarachnoid haemorrhage. The role of TNF-α is known in neurodegenerative disorders, where levels of proinflammatory factors, including TNF-α, IL-1 and IL-6, are increased both in serum and in CSF. Assessment of cytokine levels in CSF may be an additional evaluation tool in the management of CNS disorders in children, especially those of inflammatory background. Therapeutic agents for specific cytokines could be a future tool in the treatment of inflammatory diseases.

show abstract

“…The calculated cell-index in CSF could help in the diagnosis, but can fluctuate and a clear cut-off value for proven infection has not been established [2,8]. Recent studies suggest the role of different cytokines measured in CSF in the diagnosis of EVD-related ventriculitis, but this finding has not yet been validated [9]. Finally, microbiological CSF culture is nowadays the most reliable diagnostic tool, but its results can be delayed for up to 48 hours and false positive or negative results are possible.…”

Section: Introductionmentioning

confidence: 99%

Diagnosing external ventricular drain-related ventriculitis by means of local inflammatory response: soluble triggering receptor expressed on myeloid cells-1

et al. 2014

View full text Add to dashboard Cite

IntroductionExternal ventricular drainage (EVD)-related ventriculitis is one of the most severe complications associated with the use of EVDs. Establishing an early and certain diagnosis can be difficult in critically ill patients. We performed this prospective study to evaluate the usefulness of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) determination in cerebrospinal fluid (CSF) in the diagnosis of ventriculitis.MethodsA prospective observational study was conducted of 73 consecutive patients with EVD. Samples of CSF for culture, cytobiochemical analysis and sTREM-1 determination were extracted three times a week. Ventriculitis diagnosis required a combination of microbiological, cytobiochemical and clinical criteria.ResultsSeventy-three consecutive patients were included. EVD-related ventriculitis was diagnosed in six patients and EVD-colonization in ten patients. Patients without clinical or microbiological findings were considered controls. The median CSF sTREM-1 was 4,320 pg/ml (interquartile range (IQR): 2,987 to 4,886) versus 266 pg/ml (118 to 689); P <0.001. There were no differences when comparing colonized-patients and controls. The best cut-off sTREM-1 value for the diagnosis of ventriculitis was 2,388.79 pg/ml (sensitivity 100%, specificity 98.5%, positive predictive value 85.71%, negative predictive value 100%). CSF proteins, glucose and the ratio CSF/serum glucose were also significantly different (P = 0.001). Serum biomarkers were not useful to diagnose EVD-related infection. These results were confirmed by a case–control study with ventriculitis patients (cases) and non-ventriculitis (control subjects) matched by age, comorbidities, severity scales and EVD duration (P = 0.004).ConclusionsCSF sTREM-1 was useful in the diagnosis of ventriculitis, in a similar measure to classical CSF parameters. Furthermore, CSF sTREM-1 could prove the diagnosis in uncertain cases and discriminate between EVD-colonization and infection.

show abstract

Immediate diagnosis of ventriculits: evaluation of parameters independent of microbiological culture

Cited by 12 publications

References 31 publications

Bacterial external ventricular catheter-associated infection

Bacterial external ventricular catheter-associated infection

Cytokine detection in cerebrospinal fluid in central nervous system diseases in children

Diagnosing external ventricular drain-related ventriculitis by means of local inflammatory response: soluble triggering receptor expressed on myeloid cells-1

Contact Info

Product

Resources

About