Healthcare-Acquired Meningitis and Ventriculitis

Healthcare-associated meningitis and cerebral ventriculitis are infections following craniotomies, spine surgeries, CSF shunt, CSF drain surgeries, and otorhinological surgeries. Gram-positive cocci like Staphylococcus epidermidis and S. aureus are the most common pathogens, followed by gram-negative rods and anaerobes like C. acnes (formerly P. acnes). Other noninfectious neurologic conditions and neurosurgeries can cause similar clinical and CSF findings making the diagnosis difficult. The management of these infections often requires surgical interventions and may need intraventricular or intrathecal administration of antimicrobials, when they don’t respond to IV antimicrobials alone. Periprocedural antimicrobials, antimicrobial-impregnated CSF catheters, and infection prevention protocols during insertion and maintenance of CSF shunts and drains have been shown to reduce infection rates.