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中枢神经系统感染与神经设备相关。

Central nervous system infections associated with neurologic devices.

机构信息

Department of Medicine (Infectious Diseases), Vanderbilt University Medical Center, Nashville, Tennessee.

Section of Infectious Diseases, UT Health McGovern Medical School, Houston, Texas, USA.

出版信息

Curr Opin Infect Dis. 2021 Jun 1;34(3):238-244. doi: 10.1097/QCO.0000000000000723.

Abstract

PURPOSE OF REVIEW

To review recent data on the epidemiology, microbiology, diagnosis, and management of central nervous system (CNS) infections associated with neurologic devices.

RECENT FINDINGS

The increasing use of implanted neurologic devices has led to an increase in associated infections. Cerebrospinal fluid (CSF) inflammation may be present after a neurosurgical procedure, complicating the diagnosis of CNS infection. Newer biomarkers such as CSF lactate and procalcitonin show promise in differentiating infection from other causes of CSF inflammation. Molecular diagnostic tests including next-generation or metagenomic sequencing may be superior to culture in identifying pathogens causing healthcare-associated ventriculitis and meningitis.

SUMMARY

Neurologic device infections are serious, often life-threatening complications. Rapid recognition and initiation of antibiotics are critical in decreasing morbidity. Device removal is usually required for cure.

摘要

目的综述

回顾与神经设备相关的中枢神经系统(CNS)感染的流行病学、微生物学、诊断和治疗的最新数据。

最近的发现

随着植入式神经设备的使用越来越多,相关感染也有所增加。神经外科手术后可能出现脑脊液(CSF)炎症,使 CNS 感染的诊断变得复杂。新的生物标志物,如 CSF 乳酸和降钙素原,在区分感染与其他 CSF 炎症原因方面显示出一定的前景。包括下一代或宏基因组测序在内的分子诊断检测在确定导致医疗保健相关性脑室炎和脑膜炎的病原体方面可能优于培养。

总结

神经设备感染是严重的、危及生命的并发症。快速识别和启动抗生素治疗对于降低发病率至关重要。治愈通常需要移除设备。

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