eprintid: 37428
rev_number: 15
userid: 7460
dir: disk0/00/03/74/28
datestamp: 2019-09-28 23:55:45
lastmod: 2019-09-28 23:55:45
status_changed: 2019-09-28 23:55:45
type: thesis
succeeds: 36441
metadata_visibility: show
eprint_status: archive
creators_name: Sabnis, Saniya
creators_email: sss88@pitt.edu
creators_id: sss88
contributors_type: committee_chair
contributors_type: committee_member
contributors_name: Martinson, Jeremy
contributors_name: Yassin, Mohamed
contributors_email: jmartins@pitt.edu
contributors_email: yassinm@upmc.edu
contributors_id: jmartins
contributors_id: mhy8
title: Infection prevention measures to reduce external ventricular device-related surgical meningitis and ventriculitis
ispublished: unpub
divisions: sch_gsph_infectiousdiseasesmicrobiology
full_text_status: public
abstract: 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.
date: 2019-08-27
date_type: submitted
pages: 60
institution: University of Pittsburgh
refereed: TRUE
thesis_type: masteressay
degree: MPH
citation:   Sabnis, Saniya  (2019) Infection prevention measures to reduce external ventricular device-related surgical meningitis and ventriculitis.  Master Essay, University of Pittsburgh.   
document_url: http://d-scholarship-dev.library.pitt.edu/37428/1/Sabnis%20Saniya_IDM%20Essay_MPH_Aug2019.pdf