Prevention of infection in neurosurgery: role of “antimicrobial” catheters

Catheters are used in neurosurgery mainly forcerebrospinal fluid (CSF) drainage, taking the formof either shunts or external ventricular drainage(EVD) devices. While approximately 4000 shuntsare inserted each year in the UK (UK ShuntRegistry, unpublished data), numbers are notavailable for EVDs but they are certainly higher.CSF shunts are used for permanent managementof intracranial pressure in hydrocephalus, whileEVDs are used for short-term (2 3 days to 2 3weeks) management of intracranial pressure dueto subarachnoid haemorrhage, trauma, tumoursor infection. In each case, infection is a seriouscomplication associated with poor outcome.Totallyinternal devices such as shunts are classified asCategory 1 devices, whereas EVDs are partiallyimplanted and are therefore Category 2 devices