2017 Infectious Diseases Society of America’s Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis*

  • Allan R. Tunkel
    Department of Internal Medicine—Infectious Diseases, Warren Alpert Medical School of Brown University, Providence, Rhode Island;
  • Rodrigo Hasbun
    Department of Infectious Diseases, the University of Texas Health Science Center at Houston, Texas;
  • Adarsh Bhimraj
    Department of Infectious Diseases, Cleveland Clinic, Ohio;
  • Karin Byers
    Division of Infectious Diseases, University of Pittsburgh Medical Center, Pennsylvania;
  • Sheldon L. Kaplan
    Department of Pediatrics—Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas;
  • W. Michael Scheld
    Division of Infectious Diseases, University of Virginia, Charlottesville;
  • Diederik van de Beek
    Department of Neurology, Academic Medical Center, Amsterdam Neuroscience, University of Amsterdam, The Netherlands;
  • Thomas P. Bleck
    Departments of Neurological Sciences, Neurosurgery, Anesthesiology, and Medicine, Rush Medical College, Chicago, Illinois;
  • Hugh J.L. Garton
    Department of Neurological Surgery, University of Michigan, Ann Arbor; and
  • Joseph R. Zunt
    Departments of Neurology, Global Health, Medicine—Infectious Diseases, and Epidemiology, University of Washington, Seattle.

Abstract

<jats:title>Abstract</jats:title><jats:p>The Infectious Diseases Society of America (IDSA) Standards and Practice Guidelines Committee collaborated with partner organizations to convene a panel of 10 experts on healthcare-associated ventriculitis and meningitis. The panel represented pediatric and adult specialists in the field of infectious diseases and represented other organizations whose members care for patients with healthcare-associated ventriculitis and meningitis (American Academy of Neurology, American Association of Neurological Surgeons, and Neurocritical Care Society). The panel reviewed articles based on literature reviews, review articles and book chapters, evaluated the evidence and drafted recommendations. Questions were reviewed and approved by panel members. Subcategories were included for some questions based on specific populations of patients who may develop healthcare-associated ventriculitis and meningitis after the following procedures or situations: cerebrospinal fluid shunts, cerebrospinal fluid drains, implantation of intrathecal infusion pumps, implantation of deep brain stimulation hardware, and general neurosurgery and head trauma. Recommendations were followed by the strength of the recommendation and the quality of the evidence supporting the recommendation. Many recommendations, however, were based on expert opinion because rigorous clinical data are not available. These guidelines represent a practical and useful approach to assist practicing clinicians in the management of these challenging infections.</jats:p>

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