{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T11:43:10Z","timestamp":1772797390364,"version":"3.50.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2019,7,14]],"date-time":"2019-07-14T00:00:00Z","timestamp":1563062400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"MRC Confidence in Concept grant","award":["CiC2017004"],"award-info":[{"award-number":["CiC2017004"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>External ventricular drainage (EVD) carries a high risk of ventriculitis, increasingly caused by MDR Gram-negative bacteria such as Escherichia coli and Acinetobacter baumannii. Existing antimicrobial EVD catheters are not effective against these, and we have developed a catheter with activity against MDR bacteria and demonstrated the safety of the new formulation for use in the brain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Our aim was to determine the ability of a newly formulated impregnated EVD catheters to withstand challenge with MDR Gram-negative bacteria and to obtain information about its safety for use in the CNS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Catheters impregnated with three antimicrobials (rifampicin, trimethoprim and triclosan) were challenged in flow conditions at four weekly timepoints with high doses of MDR bacteria, including MRSA and Acinetobacter, and monitored for bacterial colonization. Catheter segments were also inserted intracerebrally into Wistar rats, which were monitored for clinical and behavioural change, and weight loss. Brains were removed after either 1\u2009week or 4\u2009weeks, and examined for evidence of inflammation and toxicity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Control catheters colonized quickly after the first challenge, while no colonization occurred in the impregnated catheters even after the 4\u2009week challenge. Animals receiving the antimicrobial segments behaved normally and gained weight as expected. Neurohistochemistry revealed only surgical trauma and no evidence of neurotoxicity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The antimicrobial catheter appears to withstand bacterial challenge for at least 4\u2009weeks, suggesting that it might offer protection against infection with MDR Gram-negative bacteria in patients undergoing EVD. It also appears to be safe for use in the CNS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkz293","type":"journal-article","created":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T18:05:04Z","timestamp":1561485904000},"page":"2959-2964","source":"Crossref","is-referenced-by-count":13,"title":["An external ventricular drainage catheter impregnated with rifampicin, trimethoprim and triclosan, with extended activity against MDR Gram-negative bacteria: an in vitro and in vivo study"],"prefix":"10.1093","volume":"74","author":[{"given":"Roger","family":"Bayston","sequence":"first","affiliation":[{"name":"School of Medicine, University of Nottingham, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waheed","family":"Ashraf","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nottingham, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Pelegrin","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nottingham, Nottingham, UK"},{"name":"Infectious Diseases Department, Hospital Universitari de Bellvitge-IDIBELL, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Fowkes","sequence":"additional","affiliation":[{"name":"Department of Neuropathology, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison S","family":"Bienemann","sequence":"additional","affiliation":[{"name":"Institute of Clinical Neurosciences, Faculty of Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William G B","family":"Singleton","sequence":"additional","affiliation":[{"name":"Institute of Clinical Neurosciences, Faculty of Health Sciences, University of Bristol, Bristol, UK"},{"name":"Department of Paediatric Neurosurgery, Bristol Royal Hospital for Children, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian S","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Neuropathology, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,7,13]]},"reference":[{"key":"2019092005515156400_dkz293-B1","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1007\/s12028-011-9647-z","article-title":"Strategies to decrease the risk of ventricular catheter infections: a review of the evidence","volume":"16","author":"Babu","year":"2011","journal-title":"Neurocrit Care"},{"key":"2019092005515156400_dkz293-B2","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1136\/jnnp.73.6.759","article-title":"Failure of regular external ventricular drain exchange to reduce cerebrospinal fluid infection: result of a randomised controlled trial","volume":"73","author":"Wong","year":"2002","journal-title":"J Neurol Neurosurg Psychiatr"},{"key":"2019092005515156400_dkz293-B3","doi-asserted-by":"crossref","first-page":"E12.","DOI":"10.3171\/2013.2.FOCUS12271","article-title":"Rates and determinants of ventriculostomy-related infections during a hospital transition to use of antibiotic-coated external ventricular drains","volume":"34","author":"Wright","year":"2013","journal-title":"Neurosurg Focus"},{"key":"2019092005515156400_dkz293-B4","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1080\/02688690600999901","article-title":"External ventricular drain infection: the effect of a strict protocol on infection rates and a review of the literature","volume":"20","author":"Dasic","year":"2006","journal-title":"Br J Neurosurg"},{"key":"2019092005515156400_dkz293-B5","doi-asserted-by":"crossref","first-page":"725","DOI":"10.3171\/jns.2003.98.4.0725","article-title":"Efficacy of antimicrobial-impregnated external ventricular drain catheters: a prospective, randomized, controlled trial","volume":"98","author":"Zabramski","year":"2003","journal-title":"J Neurosurg"},{"key":"2019092005515156400_dkz293-B6","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.jinf.2010.03.030","article-title":"Do antibiotic-impregnated catheters prevent infection in CSF diversion procedures? 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