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Infection prevention measures to reduce external ventricular device-related surgical meningitis and ventriculitis

Sabnis, Saniya (2019) Infection prevention measures to reduce external ventricular device-related surgical meningitis and ventriculitis. Master Essay, University of Pittsburgh.

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Introduction: Healthcare-associated infections (HAIs) are serious public health problems with significant morbidity and mortality. The reduction of intra-cranial pressure using external ventricular drains (EVDs) is a life saving measure. Unfortunately, infection is a major complication of this procedure. Therefore, reducing surgical meningitis and ventriculitis, or EVD-related infection, is an important goal for healthcare infection prevention teams.
Methods: This is a single center study performed at an academic medical center reviewing all EVD-related infections between January 2014 and October 2018. This is a pre- and post-study comparing the rates of meningitis and ventriculitis after EVD placement before and after application of infection prevention. The patients were selected using procedure ICD codes via electronic medical records (EMR). A confirmed infection was defined as a positive microbiological culture of the cerebrospinal fluid (CSF); a possible infection was defined as a high white blood cell count (>100 cells/ ml) and/ or a low glucose count (<40 mg/dl) in CSF.
Results: During the study period, there were 106 procedures performed with 85 before and 20 after the prevention. Infection occurred in 44 with 7 confirmed and 37 possible infections. There were 36 infections before and 8 infections after application of the infection prevention bundle. The number of EVD days, EVD placement procedure (bedside vs. operation room), and CSF specimen source (EVD bag vs. buretrol) were associated with increased risk of infection.
Conclusion: An EVD-related infection is a serious life-threatening HAI. Multiple risk factors were identified in this study including duration of EVD, EVD placement procedure, and CSF specimen source. The application of an effective evidence-based infection prevention bundle to reduce EVD-related surgical meningitis and ventriculitis is an essential intervention.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Sabnis, Saniyasss88@pitt.edusss88
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairMartinson, Jeremyjmartins@pitt.edujmartinsUNSPECIFIED
Committee MemberYassin, Mohamedyassinm@upmc.edumhy8UNSPECIFIED
Date: 27 August 2019
Date Type: Submission
Number of Pages: 60
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Infectious Diseases and Microbiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 28 Sep 2019 23:55
Last Modified: 28 Sep 2019 23:55

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