ORIGINAL RESEARCH Early monitoring of ventriculostomy-related infections with procalcitonin in patients with ventricular drains Amr S. Omar • Amr ElShawarby • Rajvir Singh Received: 20 August 2014 / Accepted: 27 January 2015 / Published online: 1 February 2015 Ó Springer Science+Business Media New York 2015 Abstract Several factors are implicated in the increased vulnerability of multiple trauma victims to infection, especially in intensive care units. The incidence of EVD related infections ranges from 5 to 20 %. To assess the accuracy of serum procalcitonin (PCT) in predicting cen- tral nervous system (CNS) infection in patients with EVDs. Thirty-six adult patients with severe head trauma were enrolled in this prospective study, after exclusion of other causes of fever; patients were subjected to sampling of C-reactive protein (CRP), PCT, and cerebrospinal fluid (CSF) cultures every other day. Five patients developed ventriculostomy-related infections, and all had an elevated serum PCT concentration. Patients with negative CSF cultures had mean serum PCT \ 2.0 ng/ml, while patients with positive culture had early elevation of serum PCT with mean of 4.18 ng/ml, CRP did not show similar early changes. Patients who acquire CNS infection had prolonged length of stay in hospital and length of ventila- tion. In absence of other nosocomial infections, early high serum PCT concentrations appear to be a reliable indicator of bacterial CNS infection in patients with EVD. Keywords Procacitonin Á External ventricular drain Á Meningitis Abbreviations APACHE II Acute physiology and chronic health evaluation score II CDC Centers for Disease Control and Prevention CNS Central nervous system CSF Cerebrospinal fluid CRP C-reactive protein DC Decompressive craniectomy ECL Electrochemiluminescence EVD External ventricular drain GCS Glasgow coma scale ICP Intracranial pressure ICU Intensive care unit ICULOS Length of stay in ICU ICULOV Length of ventilation in ICU MRSA Methicillin-resistant staphylococcus aureus PCT Procalcitonin T max Maximum temperature WBC White blood cell count 1 Introduction Procalcitonin (PCT) has been widely studied as a marker for bacterial infection and the utility of PCT as an indicator A. S. Omar (&) Department of Cardiothoracic Surgery/Cardiac Anaesthesia & ICU Section, Heart Hospital, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar e-mail: a_s_omar@yahoo.com A. S. Omar Faculty of Medicine, Beni Suef University, Beni Suef, Egypt A. ElShawarby Tawam Hospital, Abu Dhabi, UAE e-mail: shawarby@hotmail.com A. ElShawarby Mounofia University, Al-Minufya, Egypt R. Singh Biostatistics, Medial Research Department, Hamad Medical Corporation, Doha, Qatar e-mail: rsingh@hmc.org.qa 123 J Clin Monit Comput (2015) 29:759–765 DOI 10.1007/s10877-015-9663-1