DGI:ZNS-Infektionen/Nosokomiale Ventrikulitis und Meningitis/Prophylaxe und Prävention: Difference between revisions

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mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;
mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Calibri;
mso-bidi-theme-font:minor-latin;mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;\nmso-fareast-font-family:\&quot;Times New Roman\&quot;;mso-bidi-font-family:Calibri;\nmso-bidi-theme-font:minor-latin;mso-ansi-language:DE&quot;}">Es sollte im Rahmen <span class="ve-pasteProtect" style="mso-spacerun:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-spacerun:yes&quot;}"> </span>der Kathetereinlage eine perioperative antibiotische Prophylaxe erfolgen. Eine postoperative Fortführung einer prophylaktischen antibiotischen Therapie scheint keinen Benefit zu haben und sollte unterbleiben </span><span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:
mso-bidi-theme-font:minor-latin;mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;\nmso-fareast-font-family:\&quot;Times New Roman\&quot;;mso-bidi-font-family:Calibri;\nmso-bidi-theme-font:minor-latin;mso-ansi-language:DE&quot;}">Es sollte im Rahmen <span class="ve-pasteProtect" style="mso-spacerun:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-spacerun:yes&quot;}"> </span>der Kathetereinlage eine perioperative antibiotische Prophylaxe erfolgen. Eine postoperative Fortführung einer prophylaktischen antibiotischen Therapie scheint keinen Benefit zu haben und sollte unterbleiben </span><span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:
Calibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\&quot;Times New Roman\&quot;;mso-bidi-font-family:\nCalibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE&quot;}"><span class="ve-pasteProtect" style="mso-no-proof:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-no-proof:yes&quot;}">[28</span></span><ref name=":0"><span style="color: rgb(51, 51, 51)">Tunkel AR, Hasbun R, Bhimraj A, Byers K, Kaplan SL, Michael Scheld W, van de Beek D, Bleck TP, Garton HJ, Zunt JR: 2017 Infectious Diseases Society of America's Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis. Clin Infect Dis 2017; 64: e34–e65</span></ref><span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:
Calibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\&quot;Times New Roman\&quot;;mso-bidi-font-family:\nCalibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE&quot;}"><span class="ve-pasteProtect" style="mso-no-proof:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-no-proof:yes&quot;}">[28</span></span><ref name=":0"><span style="color: #333333">28. <span class="ve-pasteprotect"><span data-ve-attributes="{&quot;style&quot;:&quot;mso-tab-count:1&quot;}" style="box-sizing: inherit">          <span style="box-sizing: inherit"> </span></span></span>Tunkel AR, Hasbun R, Bhimraj A, Byers K, Kaplan SL, Michael Scheld W, van de Beek D, Bleck TP, Garton HJ, Zunt JR: 2017 Infectious Diseases Society of America's Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis. Clin Infect Dis 2017; 64: e34–e65</span></ref><span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:
Calibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\&quot;Times New Roman\&quot;;mso-bidi-font-family:\nCalibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE&quot;}"><span class="ve-pasteProtect" style="mso-no-proof:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-no-proof:yes&quot;}">]</span></span><span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family:
Calibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\&quot;Times New Roman\&quot;;mso-bidi-font-family:\nCalibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE&quot;}"><span class="ve-pasteProtect" style="mso-no-proof:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-no-proof:yes&quot;}">]</span></span><span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family:
&quot;Times New Roman&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;
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&quot;Times New Roman&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;
&quot;Times New Roman&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;
mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\n\&quot;Times New Roman\&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;\nmso-ansi-language:DE&quot;}">. Des Weiteren erhöht eine häufige Liquorentnahme über das Kathetersystem die Infektionsrate, so dass die Probeabnahme auf das erforderliche Maß reduziert werden sollte</span> <span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:
mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\n\&quot;Times New Roman\&quot;;mso-bidi-font-family:Calibri;mso-bidi-theme-font:minor-latin;\nmso-ansi-language:DE&quot;}">. Des Weiteren erhöht eine häufige Liquorentnahme über das Kathetersystem die Infektionsrate, so dass die Probeabnahme auf das erforderliche Maß reduziert werden sollte</span> <span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:
Calibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\&quot;Times New Roman\&quot;;mso-bidi-font-family:\nCalibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE&quot;}"><span class="ve-pasteProtect" style="mso-no-proof:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-no-proof:yes&quot;}">[30</span></span><ref><span style="color: rgb(51, 51, 51)">Beer R, Lackner P, Pfausler B, Schmutzhard E: Nosocomial ventriculitis and meningitis in neurocritical care patients.</span> <span class="ve-pasteProtect" style="color: rgb(51, 51, 51)" data-ve-attributes="{&quot;style&quot;:&quot;mso-ansi-language:DE&quot;}">J Neurol 2008; 255(11):1617-1624</span><br /></ref><span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:
Calibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;font-size:12.0pt;mso-fareast-font-family:\&quot;Times New Roman\&quot;;mso-bidi-font-family:\nCalibri;mso-bidi-theme-font:minor-latin;mso-ansi-language:DE&quot;}"><span class="ve-pasteProtect" style="mso-no-proof:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-no-proof:yes&quot;}">[30</span></span><ref><span style="color: #333333">30. <span class="ve-pasteprotect"><span data-ve-attributes="{&quot;style&quot;:&quot;mso-tab-count:1&quot;}" style="box-sizing: inherit">          <span style="box-sizing: inherit"> </span></span></span>Beer R, Lackner P, Pfausler B, Schmutzhard E: Nosocomial ventriculitis and meningitis in neurocritical care patients.</span> <span data-ve-attributes="{&quot;style&quot;:&quot;mso-ansi-language:DE&quot;}" style="box-sizing: inherit"><span class="ve-pasteprotect">J Neurol 2008; 255(11):1617-1624</span></span>
 
<span data-ve-attributes="{&quot;style&quot;:&quot;mso-ansi-language:\nDE&quot;}" style="box-sizing: inherit"> </span></ref><span class="ve-pasteProtect" style="font-size:12.0pt;mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:
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Revision as of 12:46, 25 May 2021

Prophylaxe/Prävention

Es sollte im Rahmen  der Kathetereinlage eine perioperative antibiotische Prophylaxe erfolgen. Eine postoperative Fortführung einer prophylaktischen antibiotischen Therapie scheint keinen Benefit zu haben und sollte unterbleiben [28[1]]. Die Verwendung von antimikrobiell beschichteten Kathetersystemen könnte vorteilhaft sein, wobei die Datenlage hierzu ambivalent ist.

Obwohl bei externen Liquorableitungen die Infektionsrate mit zunehmender Liegedauer ansteigt, geht ein elektiver Wechsel des Kathetersystems nicht mit einer geringeren Infektionsrate einher [28[1]]. Nicht mehr benötigte externe Liquorableitungen sollten frühzeitig entfernt werden [28[1]]. Des Weiteren erhöht eine häufige Liquorentnahme über das Kathetersystem die Infektionsrate, so dass die Probeabnahme auf das erforderliche Maß reduziert werden sollte [30[2]].

  1. ↑ 1.0 1.1 1.2 28.            Tunkel AR, Hasbun R, Bhimraj A, Byers K, Kaplan SL, Michael Scheld W, van de Beek D, Bleck TP, Garton HJ, Zunt JR: 2017 Infectious Diseases Society of America's Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis. Clin Infect Dis 2017; 64: e34–e65
  2. ↑ 30.            Beer R, Lackner P, Pfausler B, Schmutzhard E: Nosocomial ventriculitis and meningitis in neurocritical care patients. J Neurol 2008; 255(11):1617-1624
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