Bacterial external ventricular catheter-associated infection

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.