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Resistant microorganisms are public health problems because they affect the treatment of infectious diseases and the survival of patients. Neurosurgical procedures with placement of intracranial pressure monitoring and external ventricular drainage devices are related to increased morbidity and mortality. In Brazil, there are several multicenter studies demonstrating the prevalence and types of resistant microorganisms, however, there is a lack of data related to central nervous system infections associated with invasive devices, which can have a direct impact on prevention and treatment policies.
Neurosurgical procedures with placement of devices are related to increased morbidity and mortality. A study shows that the incidence of device-related central nervous system infection can reach 27%. A meta-analysis published in 2015, which included 35 studies, showed an incidence of 11.4 per 1000 catheters-day.
This is a prospective cohort study, including adult patients, in the ICUs of hospitals participating in the IMPACTO MR Platform, who have a catheter device for monitoring intracranial pressure or external ventricular shunt, with infection densities and microbiological profile being evaluated; risk factors; clinical management; costs involved and short- and long-term clinical outcomes
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| Measure | Description | Time Frame |
|---|---|---|
| Incidence density of central nervous system infection | Incidence density will be reported as number of CNS infections per 1000 catheters/day, together with 95% CI. Cumulative incidence will also be reported. | 30 days after study inclusion |
| Measure | Description | Time Frame |
|---|---|---|
| Microbiological characteristics | Microbiological characteristics of device-related central nervous system infections, considering the prevalence of microorganisms (multi-resistant or not) | 30 days after study inclusion |
| Risk factors |
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Inclusion Criteria:
Exclusion Criteria:
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Adults admitted to Intensive Care Units.
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| Name | Affiliation | Role |
|---|---|---|
| Viviane Veiga, PhD | Beneficencia Portuguesa Sao Paulo | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Unimed Vitória | Vitória | Espírito Santo | Brazil | |||
| Hospital Geral Cleriston Andrade |
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Risk factors for the development of central nervous system infections in the population studied: institution-associated, operator-associated, patient-associated
| 30 days after study inclusion |
| Treatment | Treatment practices, focusing on: antimicrobials (time and duration) and focus management (device removal versus maintenance) | 30 days after study inclusion |
| Costs | Costs associated with the duration of infection | 30 days after study inclusion |
| Deaths | Deaths during hospital stay and long-term (6 months) | 30 days and 6 months after study inclusion |
| Rankin scale | Measures the degree of disability or dependence in the daily activities of people who have suffered a stroke or other causes of neurological disability. The patient is classified as follows:
| 30 days and 6 months after study inclusion |
| Feira de Santana |
| Estado de Bahia |
| Brazil |
| Hospital da Cidade | Salvador | Estado de Bahia | Brazil |
| Santa Casa de Belo Horizonte | Belo Horizonte | Minas Gerais | Brazil |
| Santa Casa de Misericórdia de Passos | Passos | Minas Gerais | Brazil |
| Santa Casa de Misericórdia de São João del Rei | São João del Rei | Minas Gerais | Brazil |
| Instituto Estadual do Cérebro Paulo Niemeyer (Pró Saúde- Associação Beneficente de Assistência Social e Hospitalar) | Rio de Janeiro | Rio de Janeiro | Brazil |
| Hospital Universitário Onofre Lopes | Natal | Rio Grande do Norte | Brazil |
| Hospital de Clinicas de Porto Alegre | Porto Alegre | Rio Grande do Sul | Brazil |
| Instituto Baía Sul de Ensino e Pesquisa Irineu May Brodbeck | Florianópolis | Santa Catarina | Brazil |
| Hospital de Amor (Fundação PIO XII - Barretos) | Barretos | São Paulo | Brazil |
| Hospital Unimed Limeira | Limeira | São Paulo | Brazil |
| Hospital das Clínicas - FMUSP Ribeirão Preto | Ribeirão Preto | São Paulo | Brazil |
| Hospital e Maternidade Brasil (Rede D´or São Luis) | Santo André | São Paulo | Brazil |
| Beneficência Portuguesa de São Paulo | São Paulo | São Paulo | Brazil |
| Hospital do Coração | São Paulo | São Paulo | Brazil |
| Hospital São Luiz Itaim | São Paulo | São Paulo | Brazil |
| Hospital São Paulo | São Paulo | São Paulo | Brazil |
| ID | Term |
|---|---|
| D002494 | Central Nervous System Infections |
| ID | Term |
|---|---|
| D007239 | Infections |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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