• Mirza Faisal Ahmed Rafiq
  • Noor Ahmed
  • Shafqut Ali
  • Muhammad Naseem Khan
  • Khaleeq -uz- Zaman


Background: External ventricular (EVD) is a life saving procedure and involves insertion of a catheterin ventricular space to drain cerebrospinal fluid (CSF). Our objective of this study was to determine theculture and sensitivity (C/S) pattern in patients with EVD infection. Methods: This cross sectional studywas conducted in Department of Neurosurgery, Pakistan Institute of Medical Sciences (PIMS),Islamabad from December 1, 2008 to January 31, 2010. All admitted patients who had acutehydrocephalus, underwent EVD insertion after excluding meningitis and ventriculitis by physicalexamination and per operative CSF sampling. The EVD was done at right Kocher’s point. Prophylacticthird generation antibiotic (Ceftriaxone) was started and continued till EVD was in place. C/S was sent toPIMS laboratory on first documented fever and or change of CSF color or when plan was to replaceEVD with Ventriculo-peritoneal shunt (VP). Once infection was there CSF was sent for C/S initially androutine examination (R/E) daily. Antibiotics were changed according to C/S report and continued tillthey were needed. Infection rate was also estimated. Results: Among 76 patients 41 (53.9%) were maleand 35 (46.1%) were females. Most were adults and were between 31 to 40 years of age. Mean durationof EVD was 11.41 days. Overall infection rate was 11.8%. Among causative organisms StaphylococcusAureus (44.4%) was most common followed by Acenitobacter and Enterobacter and commonly usedprophylactic antibiotic (Ceftriaxone) had considerable resistance. Conclusion: EVD is a simple and lifesaving procedure. Most common organisms causing infection are Staphylococcus Aureus followed byAcenitobacter. Conventional used antibiotic Ceftriaxone has considerable resistance.Keywords: External Ventricular Drain, organisms, antibiotics


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