Letter : ventricular catheter tract hemorrhage as a risk factor for ventriculostomy-related infection

Abstract

We read with interest the study of Kim et al “Ventricular Catheter Tract Hemorrhage as a Risk Factor for Ventriculostomy-Related Infection”.1 The authors conclude that ventricular catheter tract hemorrhage (VCTH) is a risk factor for the development of ventriculostomy-related infection (VRI) since the hemorrhage may serve as a nidus for bacterial penetration. Little is known about the role of VCTH and the risk of developing VRI. Ventriculostomy is a therapeutic tool for neurosurgeons. The management of ventricular drainage device leads to potential risks and complications and the most feared is infection, especially ventriculitis.2,3 The presence of central nervous system infections increases the mortality of patients with acute neurological injury.4 Extrinsic and intrinsic factors may be associated with the development of VRI. Considering intrinsic factors, we can mention immunosuppression, previous infection, and systemic infection, among others. Extrinsic factors may include the surgical technique, potential contamination during surgical steps, and shunt devices, among others.

Considering the results presented by Kim et al,1 we would like to know the opinion of the authors on the following question: Should surgeons start prolonged antibiotic treatment (more than 48 h) if a postoperative computed tomography (CT) scan demonstrated VCTH?