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lüll Reduction in external ventricular drain infection rate Impact of a minimal handling protocol and antibiotic-impregnated catheters Rivero-Garvia M; Marquez-Rivas J; Jimenez-Mejias ME; Neth O; Rueda-Torres ABActa Neurochir (Wien) 2011[Mar]; 153 (3): 647-51INTRODUCTION: Many strategies have been developed with the aim of reducing external ventricular drain-related infections. Antibiotic-impregnated catheters are one of them. MATERIAL AND METHODS: We report 648 cases of external ventricular drain from a total of 534 patients treated at the Virgen del Rocio Hospital between 1995 and 2006. Three subgroups were considered: group 1 included patients treated between 1995 and 2000, as well as a total of 190 external ventricular drains and 59 cases of infection (31.05%); group 2, with patients treated between 2000 and 2004 and managed with a minimal handling protocol, included 210 external ventricular drains and nine cases of infection (4.29%); and group 3, treated between 2004 and 2006, with 248 external ventricular drains and six cases of infection (2.41%). This latter subgroup included patients managed with a minimal handling protocol and antibiotic-impregnated catheters. RESULTS: Infection rate was 17% when non-antibiotic-impregnated catheters were employed and 2.41% when antibiotic-impregnated catheters were inserted (p < 0.001). This difference was statistically significant before and after the introduction of a minimal handling protocol, with percentages of 5.31% and 3.27%, respectively (p < 0.001; odds ratio 0.08; absolute risk reduction 27.26%). However, no statistically significant difference was observed in infection rate when the impact of a minimal handling protocol was considered: 4.29% when only the protocol was introduced and 2.41% when both the protocol and antibiotic-impregnated catheters were used (p > 0.05). CONCLUSION: Minimal handling protocols constitute an essential strategy in the reduction of external ventricular drain-related infections. Besides that, the use of antibiotic-impregnated catheters may reduce infection-related hospital costs.|*Antibiotic Prophylaxis[MESH]|*Coated Materials, Biocompatible[MESH]|*Staphylococcus aureus[MESH]|*Staphylococcus epidermidis[MESH]|Anti-Bacterial Agents/*administration & dosage[MESH]|Catheters, Indwelling/*microbiology[MESH]|Cerebrospinal Fluid Shunts/*instrumentation[MESH]|Cerebrospinal Fluid/microbiology[MESH]|Clindamycin/*administration & dosage[MESH]|Cross Infection/*prevention & control[MESH]|Equipment Contamination/*prevention & control[MESH]|Humans[MESH]|Rifampin/*administration & dosage[MESH]|Staphylococcal Infections/*prevention & control[MESH]|Surgical Wound Infection/*prevention & control[MESH]|Vancomycin/*administration & dosage[MESH] |