Silver-impregnated external-ventricular-drain-related cerebrospinal fluid infections: a meta-analysis

Atkinson, Ross; Fikrey, Lubna; Vail, Andy; Patel, Hiren C.

doi:10.1016/j.jhin.2015.09.014

Cited by 42 publications

(28 citation statements)

References 21 publications

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“…More than 80% of infectious cases have been caused by MRSA [130]. Catheters coated with Ag NP have been developed to protect patients from such infections [131,132,133]. Approaches for preventing infections caused by both Gram-negative and Gram-positive bacteria have been reported [128,134,135,136].…”

Section: Other Medical Applicationsmentioning

confidence: 99%

Synthesis and Application of Silver Nanoparticles (Ag NPs) for the Prevention of Infection in Healthcare Workers

Nakamura

Sato

et al. 2019

IJMS

211

115

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Silver is easily available and is known to have microbicidal effect; moreover, it does not impose any adverse effects on the human body. The microbicidal effect is mainly due to silver ions, which have a wide antibacterial spectrum. Furthermore, the development of multidrug-resistant bacteria, as in the case of antibiotics, is less likely. Silver ions bind to halide ions, such as chloride, and precipitate; therefore, when used directly, their microbicidal activity is shortened. To overcome this issue, silver nanoparticles (Ag NPs) have been recently synthesized and frequently used as microbicidal agents that release silver ions from particle surface. Depending on the specific surface area of the nanoparticles, silver ions are released with high efficiency. In addition to their bactericidal activity, small Ag NPs (<10 nm in diameter) affect viruses although the microbicidal effect of silver mass is weak. Because of their characteristics, Ag NPs are useful countermeasures against infectious diseases, which constitute a major issue in the medical field. Thus, medical tools coated with Ag NPs are being developed. This review outlines the synthesis and utilization of Ag NPs in the medical field, focusing on environment-friendly synthesis and the suppression of infections in healthcare workers (HCWs).

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Section: Other Medical Applicationsmentioning

confidence: 99%

Synthesis and Application of Silver Nanoparticles (Ag NPs) for the Prevention of Infection in Healthcare Workers

Nakamura

Sato

et al. 2019

IJMS

211

115

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“…Antibiotic prophylaxis, recommended for neurosurgery, is directed mainly against Gram-positive bacteria. Similarly, antibiotics used in impregnated catheters (minocycline, rifampin, clindamycin) and silver coating are active mainly against Gram-positive bacteria and significantly reduce the PNM caused by them [19,20]. Better adherence to antibiotic prophylaxis protocols and use of impregnated catheters probably shift remaining infections to a Gram-negative spectrum.…”

Section: Aetiologymentioning

confidence: 99%

Management of post-neurosurgical meningitis: narrative review

Hussein

Bitterman

Shofty

et al. 2017

Clinical Microbiology and Infection

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“…However, it is so far not clear whether silver impregnation conveys a stronger advantage than antibiotic impregnation. 2,5,26 To date, there are more studies published for catheters with antibiotic-impregnation and therefore the data may be interpreted as stronger. Nevertheless, a recent German survey among all major neurosurgical centers showed that si-EVDs are used more often compared to ones with antibiotic impregnation.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, antimicrobial EVD catheters seem to be especially effective at preventing CSF infections with gram-positive bacteria. 2 However, there are only sparse preclinical data available on the antimicrobial effects of si-catheters 27 on different bacteria and fungi.…”

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confidence: 99%

The SiLuDrain Trial: a prospective randomized controlled trial comparing standard versus silver-impregnated lumbar drains

Jakobs¹,

Klein

Eigenbrod

et al. 2019

Journal of Neurosurgery

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OBJECTIVE Catheter-associated cerebrospinal fluid (CSF) infection remains a serious event, especially for patients in neurocritical care units. The use of external ventricular drain (EVD) catheters impregnated with antimicrobial substances has led to a significant reduction of infection rates. This study was undertaken to compare the use of antimicrobial, silver-impregnated external lumbar drains (si-ELDs) and conventional ELDs. METHODS Patients with an indication for ELD placement were randomized to receive either a conventional or an si-ELD catheter. Regular assessment for CSF infections and device-related complications was performed. Neurosurgeons placing the ELD rated the usability and handling of the catheter on a 6-item ordinal performance scale (range: 1, very bad, to 5, very good). All microorganisms isolated in this study were tested for silver-susceptibility via a catheter-roll method. RESULTS A total of 48 patients were enrolled in the trial. The si-ELD catheters showed a nonsignificantly lower infection rate compared to conventional ones (4.2% vs 16.7%, p = 0.16). The majority of infections were caused by Staphylococcus species. Device-related complications occurred significantly less often with silver-impregnated-catheters than with conventional ones (8.3% vs 37.5%, p = 0.02). The usability was rated significantly better for si-ELDs (p = 0.003). Antimicrobial susceptibility was shown for si-ELDs against various Staphylococcus spp., but Candida parapsilosis and Escherichia coli were not affected by this antimicrobial agent. CONCLUSIONS Silver-impregnated ELD catheters, which could potentially reduce the number of CSF infections, show significantly better properties in regard to handling and fewer device-related complications. Whether they are superior to antibiotic-impregnated catheters or a clinical regimen involving antibiotic prophylaxis remains to be proven. Clinical trial registration no.: DRKS00013513 (Deutsches Register Klinischer Studien).

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Silver-impregnated external-ventricular-drain-related cerebrospinal fluid infections: a meta-analysis

Cited by 42 publications

References 21 publications

Synthesis and Application of Silver Nanoparticles (Ag NPs) for the Prevention of Infection in Healthcare Workers

Synthesis and Application of Silver Nanoparticles (Ag NPs) for the Prevention of Infection in Healthcare Workers

Management of post-neurosurgical meningitis: narrative review

The SiLuDrain Trial: a prospective randomized controlled trial comparing standard versus silver-impregnated lumbar drains

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