Risk factors for nosocomial meningitis in patients with external ventricular drainages
Authors' conclusion
Key risk factors included β-lactam allergy, CSF leakage, prolonged drainage, and cerebrospinal biological profile.
Study context
- Population
- Adult ICU patients who received an external ventricular drain (EVD) in a French ICU, 2018–2022
- Participants
- 275 patients
- Exposure
- Nosocomial meningitis (NM) vs no meningitis
- NMn = 32
- Outcome
- Epidemiology of NM and its risk factors
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
NM incidence and risk factors
NM
11.6%
32
Estimate (95% CI)P value
CSF leakage at insertion site
OR 3.47(1.53–7.86)
P = 0.002Longer drainage duration
OR 1.07 per day(1.04–1.12)
P < 0.001β-lactam allergy
OR 6.83(1.73–26.92)
P = 0.002CSF cytochemical profile consistent with infectionleukocytes > 100/mm3, CSF-to-serum glucose ratio < 0.5, protein > 1 g/
OR 3.87(1.67–8.97)
P < 0.001Per day, as printed
Observational data: associations, not effects.
Further findings
ICU LOS
- Longer ICU LOS in patients with meningitis vs without: median 42.5 vs. 29 days
- P = 0.019
In-hospital mortality
- Similar between groups: 29.5% vs. 21.9%
- P = 0.668
Pathogen identified
- Pathogen identified in episodes
- 75%
Predictive model derived from identified risk factors
- AUC-ROC
- 0.89 (95% CI, 0.83-0.94)
- NPV
- 96.8%
Original publication
Risk factors for nosocomial meningitis in patients with external ventricular drainages. J Intensive Care. Published 11 November 2025. doi:10.
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