Healthcare-acquired meningitis and ventriculitis

Healthcare-associated meningitis or cerebral ventriculitis are infections complicating neurosurgeries, CSF shunt, and CSF drain surgeries. It is different in clinical presentation, pathogenesis, and management from community-acquired meningitis. Gram-positive cocci like Staphylococcus epidermidis and S. aureus are the most common pathogens, followed by Gram-negative rods and anaerobes like P. acnes. The diagnosis can be difficult as other noninfectious neurologic conditions and neurosurgeries can cause similar clinical and CSF findings. The management of these infections often requires surgical interventions and may need intraventricular or intrathecal administration of antimicrobials, as the organisms can be refractory to IV antimicrobials alone. Periprocedural antimicrobials and antimicrobial impregnated CSF catheters have been shown to reduce infection rates.