• R A Atkinson, L Fikrey, A Vail, and H C Patel.
• Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Sciences Centre, Salford, UK; Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
• J. Hosp. Infect. 2016 Mar 1; 92 (3): 263-72.

BackgroundCerebrospinal fluid (CSF) infection is the primary complication associated with placement of an external ventricular drain (EVD). The use of silver-impregnated EVD catheters has become commonplace in many neurosurgical centres.AimTo assess the effect of silver-impregnated EVD catheter usage on catheter-related CSF infections.MethodsA meta-analysis was performed by systematically searching Medline, Embase and the Cochrane Library. All randomized controlled trials (RCTs) and non-RCTs comparing silver-impregnated and plain EVD catheters were identified and analysed.FindingsSix non-RCTs were included. The crude infection rate was 10.8% for plain catheters and 8.9% for silver-impregnated catheters [pooled odds ratio (OR) 0.71, 95% confidence interval (CI) 0.46-1.08; P = 0.11]. In a microbiological spectrum analysis, silver-impregnated catheters demonstrated a significantly lower rate of CSF infections caused by Gram-positive organisms (2.0% vs 6.7% in the silver-impregnated and plain catheter groups, respectively; pooled OR 0.27, 95% CI 0.11-0.63; P = 0.002).ConclusionThe antimicrobial effects of silver-impregnated EVD catheters may be selective, and may need to be evaluated further in a prospective, controlled manner.Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

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