Evidence map›Paper›PMID 38087175›Full record

ArticleNeurocritical care2024

Broad Range Eubacterial Polymerase Chain Reaction of Cerebrospinal Fluid Reduces the Time to Exclusion of and Costs Associated with Ventriculostomy-Related Infection in Hemorrhagic Stroke.

Elisabeth Pietrzko, Stefan Bögli, Katja Frick, Sabeth Ebner-Dietler, Crescenzo Capone, Frank Imkamp, Hendrik Koliwer-Brandl, Nicolas Müller, Emanuela Keller, Giovanna Brandi

Erratum issuedOpen access · hybridAbstract read
In one paragraph

Article in Neurocritical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Observational
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Elisabeth PietrzkoNeurocritical Care Unit, Institute of Intensive Care, University Hospital of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland. elisabeth.pietrzko@uzh.ch.ORCID 0009-0004-0596-5941
Stefan BögliNeurocritical Care Unit, Institute of Intensive Care, University Hospital of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland.
Katja FrickNeurocritical Care Unit, Institute of Intensive Care, University Hospital of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland.
Sabeth Ebner-DietlerNeurocritical Care Unit, Institute of Intensive Care, University Hospital of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland.
Crescenzo CaponeNeurocritical Care Unit, Institute of Intensive Care, University Hospital of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland.
Frank ImkampInstitute of Medical Microbiology, University of Zürich, Gloriastrasse 28/30, 8006, Zürich, Switzerland.
Hendrik Koliwer-BrandlInstitute of Medical Microbiology, University of Zürich, Gloriastrasse 28/30, 8006, Zürich, Switzerland.
Nicolas MüllerDepartment of Infectious Diseases and Hospital Epidemiology, University Hospital Zürich, Rämistrasse 100, 8091, Zürich, Switzerland.
Emanuela KellerNeurocritical Care Unit, Institute of Intensive Care, University Hospital of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland.
Giovanna BrandiNeurocritical Care Unit, Institute of Intensive Care, University Hospital of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland.
University Hospital of Zurich · CHUniversity of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with hemorrhagic stroke and an external ventricular drain in situ are at risk for ventriculostomy-related-infections (VRI). Because of the contamination of the cerebrospinal fluid (CSF) with blood and the high frequency of false negative CSF culture, the diagnosis of VRI remains challenging. This study investigated the introduction of CSF broad range eubacterial polymerase chain reaction (ePCR) and its effect on frequency and duration of antibiotic therapy for VRI, neurocritical care unit (NCCU) length of stay, related costs, and outcome.

methodsBetween 2020 and 2022, we prospectively included 193 patients admitted to the NCCU of the University Hospital of Zürich with hemorrhagic stroke and an external ventricular drain for more than 48 h. Patient characteristics, serum inflammatory markers, white blood cell count in CSF, use and duration of antibiotic treatment for VRI, microbiological findings (CSF cultures and ePCR tests), and NCCU length of stay were compared in patients with no infection, noncerebral infection, suspected VRI, and confirmed VRI. Data of patients with suspected VRI of this cohort were compared with a retrospective cohort of patients with suspected VRI treated at our NCCU before the introduction of CSF ePCR testing (2013-2019).

resultsOut of 193 patients, 12 (6%) were diagnosed with a confirmed VRI, 66 (34%) with suspected VRI, 90 (47%) with a noncerebral infection, and 25 (13%) had no infection at all. Compared with the retrospective cohort of patients, the use of CSF ePCR resulted in a reduction of patients treated for suspected VRI for the whole duration of 14 days (from 51 to 11%). Furthermore, compared with the retrospective group of patients with suspected VRI (n = 67), after the introduction of CSF ePCR, patients with suspected VRI had shorter antibiotic treatment duration of almost 10 days and, hence, lower related costs with comparable outcome at 3 months.

conclusionsThe use of CSF ePCR to identify VRI resulted in shorter antibiotic treatment duration without changing the outcome, as compared with a retrospective cohort of patients with suspected VRI.

Indexed as

Anti-Bacterial AgentsHemorrhagic StrokeVentriculostomyAgedCerebrospinal FluidFemaleHumansLength of StayMaleMiddle AgedPolymerase Chain ReactionProspective StudiesRetrospective StudiesAnti-Bacterial AgentsCerebrospinal fluidEubacterial polymerase chain reactionHealth care-associated ventriculitisHemorrhagic strokeVentriculostomy-related infection

Identifiers

PMID38087175
PMCPMC11147905
OpenAlexW4389609552

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.