Prevention and Management of Ventriculitis Among Hospitalized Patients

Purpose of Review This review provides a comprehensive, critically appraised summary of recent research on the prevention and management of ventriculitis, with contextualization within the broader pre-2020 evidence base. Recent Findings Beyond confirming established risk factors such as duration of central nervous system (CNS) devices and cerebrospinal fluid (CSF) leaks, recent studies have refined risk stratification by identifying procedural and patient-level contributors. Advanced diagnostics — notably multiplex polymerase chain reaction (PCR) panels and metagenomic next-generation sequencing (mNGS) — have accelerated and broadened pathogen identification, revealing polymicrobial and fungal contributions previously under-appreciated. Novel CSF biomarkers (presepsin, HMGB-1, cell index, and cytokine profiles including the IL-17/IL-23 axis) offer incremental diagnostic and prognostic value. Management of multidrug-resistant (MDR) organisms increasingly relies on intraventricular antibiotic protocols, pharmacokinetically informed systemic dosing, and neuroendoscopic interventions. Evidence-based care bundles have continued to demonstrate sustained reductions in infection rates in long-term, multi-centre cohorts. Summary Current literature offers more granular risk stratification, improved etiological characterization via molecular diagnostics, emerging biomarkers, refined treatment strategies for complex infections, and robust real-world evidence for prevention bundles. However, methodological heterogeneity — inconsistent definitions, predominance of single-centre observational designs, and limited evidence-quality appraisal — continues to limit the generalisability of findings.