Cerebrospinal fluid shunt infection: a prospective study of risk factors

Abstract

Three variables associated with an increased incidence of shunt infection have been identified. Changes in clinical practice should address these variables, as follows. 1) Great care should be taken intraoperatively to avoid a postoperative CSF leak. 2) Alternatives to placement of a CSF shunt in premature infants should be studied. 3) Surgeons should minimize manual contact with the shunt system and consider the use of double gloves.

Early shunt complications in 46 children with hydrocephalus

“…other studies did not find differences in the infection rate between different children' s ages 13 . An increased risk of infection was only demonstrated among premature children 5 . In contrast to the literature, we observed a greater predominance of complications in the age group of 2 to 7 years.…”

“…since the present patients were only studied for a short period of time, our infection rate is probably higher than reported in that study 3 . however, in view of the difficulties encountered at Brazilian public hospitals and considering a value of 10% observed in patients with primary hydrocephalus, this rate is within an acceptable, although not ideal, limit 5 . studies on this subject are scarce in the Brazilian literature.…”

“…This reinforces the need to reduce the duration of hospitalization and to maintain special surgical wound care 11 . some investigators 5,12 have reported an important association between child's age of less than 6 months and infection of the shunt system, whose frequency was 2.6 times higher than in children older than one year. other studies did not find differences in the infection rate between different children' s ages 13 .…”

“…In a prospective study, Kulkarni et al 5 identified three basic risk factors for vPs infections: presence of a csF fistula, excessive contact with the prothesis, and child's age. The authors suggested the simultaneous use of double gloves to reduce the risk related to shunt manipulation.…”

Infecções em dispositivos neurológicos implantáveis em crianças e adolescentes

“…Diversos fatores de risco contribuem para infecção em DVP, tais como: causa da hidrocefalia, recém nascidos, inserção primária do sistema de derivação, meningite prévia, inadequada habilidade técnica da equipe cirúrgica, tempo cirúrgico longo, presença de fístula liquórica, necrose de couro cabeludo e perfuração ou infecção de vísceras abdominais [3][4][5] . Os microrganismos mais prevalentes são os Sthaphylococcus aureus (12-40%) e Sthaphylococcus epidermidis (52,8-88,9%).…”