In:
Current Opinion in Anaesthesiology, Ovid Technologies (Wolters Kluwer Health), Vol. 35, No. 5 ( 2022-10), p. 549-554
Abstract:
The aim of this review is to provide a practical and updated summary on healthcare-associated central nervous system infections and their management. Recent findings The term ‘healthcare-associated ventriculitis and meningitis’ has recently been coined and clinical practical guidelines have been published on the management of these nosocomial infections. Many aspects have still to be further investigated (e.g. cerebrospinal fluid biomarkers, indications for novel antibiotics, intrathecal antimicrobial regimens). Summary Clinicians should maintain a high index of suspicion for healthcare-associated central nervous system infections in patients with specific risk factors (i.e. recent neurosurgery, cerebrospinal shunts, drains or implantable devices, head/spinal traumatic events), taking into account systemic signs, and alterations in microbiological, imaging, cerebrospinal fluid findings. The diagnosis is often difficult to confirm because of reduced levels of consciousness or coma. Both Gram-positive and Gram-negative (often multidrug-resistant or even pandrug-resistant) microorganisms may be the cause. Selection of antibiotics must consider susceptibility and penetration into the central nervous system. Ineffective treatments are frequent, and mortality can reach 60%. Future research should focus on the diagnostic performance of biomarkers and on the use of novel antimicrobial regimens, especially for the treatment of difficult to treat infections.
Type of Medium:
Online Resource
ISSN:
0952-7907
,
1473-6500
DOI:
10.1097/ACO.0000000000001167
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2022
detail.hit.zdb_id:
2027005-7
