Article Dans Une Revue Brain - A Journal of Neurology Année : 2025

Ventriculitis characteristics and outcomes (VELCRO): an international retrospective cohort study

1 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
2 BRM - ARN bactériens et médecine
3 CIBERINFEC - Centro de Investigación Biomédica en Red de Enfermedades Infecciosas
4 IdiPaz - Hospital La Paz Institute for Health Research [Madrid, Spain]
5 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
6 Hôpital Lapeyronie [CHU Montpellier]
7 Hôpital Lariboisière-Fernand-Widal [APHP]
8 Hospital de São João [Porto]
9 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
10 Infinity - Institut Toulousain des Maladies Infectieuses et Inflammatoires
11 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
12 Hôpital Delafontaine
13 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
14 CHUGA - CHU de Grenoble-Alpes - Centre Hospitalier Universitaire CHU Grenoble
15 CHU Reims - Hôpital universitaire Robert Debré [Reims]
16 VIEFRA - EA 3797 - Vieillissement, Fragilité
17 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
18 Ege university [Izmir, Turkey]
19 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
20 APHM - Assistance Publique - Hôpitaux de Marseille
21 AMU - Aix Marseille Université
22 HCL - Hospices Civils de Lyon
23 CHU Montpellier = Montpellier University Hospital
24 UM - Université de Montpellier
25 CHU Clermont-Ferrand
26 CHU Amiens-Picardie
27 Service des Maladies infectieuses et tropicales [CHU Necker]
28 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
29 CHV - Centre Hospitalier de Versailles André Mignot
30 Hôpital Henri Mondor
31 Hôpitaux Civils de Colmar
32 Centre Hospitalier Sainte-Anne [Paris]
33 GHU Paris Psychiatrie et Neurosciences - Groupe hospitalier universitaire Paris psychiatrie & neurosciences [Paris]
34 Perception et Mémoire / Perception and Memory
35 CIRI - Centre International de Recherche en Infectiologie
Pierre Jaquet
  • Fonction : Auteur
  • PersonId : 1324308
  • IdRef : 250044250
Oguz Resat Sipahi
Baptiste Balança
Thibaut Lévèque
  • Fonction : Auteur
  • PersonId : 1300427
  • IdRef : 18251479X
Alexis Salomon
Nicolas Mongardon
  • Fonction : Auteur
  • PersonId : 1513970
Martin Martinot

Résumé

Ventriculitis is a dreaded complication of central nervous system infections, which has been scarcely described in the literature. We aimed to present a contemporary picture of ventriculitis, describing its characteristics and outcomes across the spectrum of aetiologies that may lead to ventriculitis. VELCRO is an international retrospective multicentre cohort study conducted at 34 hospitals in six countries. Adult patients fulfilling clinical, microbiological and imaging criteria of ventriculitis between 2010 and 2021 were included. Survival analyses were performed using a multivariable Cox proportional hazards regression model to identify risk factors for 1-year all-cause mortality. Overall, 436 patients with ventriculitis were included: 274 (62.8%) males, median age 58 years [interquartile range 48-68], 68 (15.6%) had diabetes mellitus and 62 (14.2%) were immunocompromised. The most common neuroimaging features of ventriculitis were ependymal enhancement (n=310/436, 71.1%), intraventricular pus (n=286/436, 65.6%) and intraventricular septations (n=85/436, 19.5%). To describe the cohort, patients were divided into three groups: ventriculitis with brain abscess(es) (V-BA, n=181), community-acquired ventriculitis without brain abscess (CA-V, n=88), and healthcare-associated ventriculitis without brain abscess (HCA-V, n=167). Intensive care unit admission was required for 351 patients (80.5%) and the median hospital length of stay was 45 days [26-74]. One-year mortality rate was 33.7% (n=147/436), with a lower rate in patients with V-BA (n=50/181, 27.6%) than in patients with CA-V (n=30/88, 34.1%) and HCA-V (n=67/167, 40.1%). On multivariable analysis, the predictive factors for 1-year mortality were: age > 60 years, immunosuppression, diabetes mellitus, Glasgow Coma Scale score < 13 at presentation, infection involving Enterobacterales or fungi, acute hydrocephalus, cerebral ischemia and intraventricular septations. Staphylococcal ventriculitis was associated with a lower 1-year mortality. Long-term unfavourable outcome (modified Rankin score (mRS) > 2 after 6 months of follow-up) occurred in 43.3% (n=91/210), considering that 26.7% (n=56) had a mRS > 2 before the onset of ventriculitis. Ventriculitis is associated with high mortality and neurological morbidity. Further large prospective studies are needed in this area of research.

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Dates et versions

hal-05107921 , version 1 (03-10-2025)

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David Luque Paz, Beatriz Diaz Pollan, Marielle Boyer-Besseyre, Flora Djanikian, Anne-Lise Munier, et al.. Ventriculitis characteristics and outcomes (VELCRO): an international retrospective cohort study. Brain - A Journal of Neurology , 2025, 149, pp.333-342. ⟨10.1093/brain/awaf178⟩. ⟨hal-05107921⟩
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