Risk factors and chlorhexidine dressings in external ventricular drainage: a retrospective analysis on infection rates

Neurosurg Rev. 2024 Sep 17;47(1):630. doi: 10.1007/s10143-024-02876-1.

Abstract

This retrospective study endeavors to scrutinize risk factors associated with infections resulting from external ventricular drainage (EVD) and to assess the effectiveness of chlorhexidine dressing in mitigating infection rates. Conducted from January 2018 to July 2023, this single-center study encompassed 108 EVD patients. Comprehensive data on demographics, comorbidities, surgical procedures, and the utilization of chlorhexidine dressing were meticulously compiled. The primary endpoint was the incidence of EVD-associated infections based on CDC criteria. Infection rates attributable to EVD were 24.32% without and 20.59% with chlorhexidine dressing. Notably, diabetes mellitus emerged as the solitary significant infection risk factor (p < 0.01). Although the application of chlorhexidine dressing suggested a propensity for diminishing infection rates, statistical significance remained elusive. No notable disparities were discerned in variables such as catheter type, procedural location, and underlying diseases. Diabetes mellitus has been identified as a significant risk factor for EVD-associated infections. While the utilization of chlorhexidine dressing exhibited a potential reduction in infection rates, the lack of statistical significance underscores the imperative for further research, encompassing more expansive randomized trials, to comprehensively evaluate the safety and efficacy of chlorhexidine dressings in preventing EVD-associated infections.

Keywords: CNS infection; Chlorhexidine; Diabetes mellitus; EVD; EVD associated infection.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents, Local / administration & dosage
  • Anti-Infective Agents, Local / therapeutic use
  • Bandages*
  • Catheter-Related Infections / epidemiology
  • Catheter-Related Infections / prevention & control
  • Chlorhexidine* / therapeutic use
  • Drainage*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / prevention & control

Substances

  • Chlorhexidine
  • Anti-Infective Agents, Local