Cerebrospinal fluid shunt infections in infants and children in Mobile, Alabama

Mancao, M.; Miller, Christopher; Cochrane, B.; Hoff, Cynthia; Sauter, Kent L.; Weber, Eric

doi:10.1080/080352598750014085

Cited by 22 publications

(18 citation statements)

References 6 publications

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“…There are reported incidence rates of up to 39%; in recent studies, the incidence ranges from 5 to 10% [10,11,12,13]. The infection rates range from 3 to 20% [3,14,15,16,17,18,19,20,21,22]. Table 1 shows the incidence and infection rates as documented in the literature.…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Epidemiology, Prevention and Management of Ventriculoperitoneal Shunt Infections in Children

Prusseit

Simon²,

Brelie³

et al. 2009

Pediatr Neurosurg

118

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The advent of ventriculoperitoneal shunts (VPS) represented a substantial progress in the neurosurgical management of hydrocephalus in children. VPS infection is the most frequently observed complication. VPS infection is related to substantial morbidity and mortality, and exerts a negative impact on the quality of life of patients. Considerable personnel and financial resources have been devoted to its diagnosis and treatment. This article reviews the current literature and includes suggestions for the prevention, diagnosis and management of VPS infections.

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Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

“…Most VPS infections are caused by Gram-positive opportunistic pathogens colonizing the skin of the patient [4,19,20,21,25,33]. Coagulase-negative staphylococci (CoNS) have been detected in 17–78% of the cases (table 2), and Staphylococcus epidermidis accounts for 47–64% of all Gram-positive VPS infections [34].…”

Section: Bacterial Pathogensmentioning

confidence: 99%

Epidemiology, Prevention and Management of Ventriculoperitoneal Shunt Infections in Children

Prusseit

Simon²,

Brelie³

et al. 2009

Pediatr Neurosurg

118

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“…However, there are very little data discussing the duration of antibiotic therapy when treating a shunt infection. Protocols in the literature vary, and in many of the large series reviewing the treatment of shunt infections, the duration of antibiotic therapy is not specified, nor is the treatment failure rate [4, 5, 6, 10, 11, 12, 13]. …”

Section: Introductionmentioning

confidence: 99%

The Treatment of Cerebrospinal Fluid Shunt Infections

Whitehead

Kestle²

2001

Pediatr Neurosurg

110

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It is our impression that the management strategy for infected cerebrospinal fluid (CSF) shunts varies significantly among pediatric neurosurgeons. The purpose of this paper is to present the results of a practice survey on the treatment of shunt infections which was distributed to all active members of the American Society of Pediatric Neurosurgeons (ASPN). Eighty-four of 129 ASPN members (65%) responded to the survey. Most ASPN members remove the shunt and place an external ventricular drain (EVD) to treat Staphylococcus epidermidis (59.5%), S. aureus (64.3%) and gram-negative rod infections (67.9%). The second most common method of treatment was externalization of the shunt (33.3, 29.8 and 25%, respectively). The duration of antibiotic treatment was extremely variable. When the shunt was removed and an EVD inserted, the duration of antibiotic treatment for S. epidermidis and S. aureus ranged from 5 to 21 total days (2–21 days of sterile cultures). For gram-negative rod infections treated with shunt removal and an EVD, the total duration of antibiotic therapy ranged from 5 to 24 days (2–37 days of sterile cultures). The majority of ASPN members remove the infected CSF shunt and place an EVD for the management of shunt infections. Significant variation exists in the duration of antibiotic therapy. Determining the most effective duration of antibiotic therapy in an effort to shorten hospitalization and minimize complications without sacrificing efficacy will require further study.

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“…The organisms implicated are most commonly coagulase-negative Staphylococcus in around 50%, and Staphylococcus aureus in a third 2–5. Infection introduced at the time of surgery usually presents within the first 8 weeks 6. Clearly every time the shunt or device is subsequently accessed has the potential to introduce infection from skin flora colonisation.…”

Section: Shunt Infectionmentioning

confidence: 99%

Fever in a child with cerebrospinal fluid access device or shunt: a pragmatic approach to management

Cleave¹,

Cartmill

Soo

et al. 2016

Arch Dis Child

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Children with shunts commonly present with fever, and often the focus of infection will be unrelated to their shunt. However, as shunt infections may present with few or even no specific symptoms, evaluation of a child with a shunt presenting with fever should be careful and comprehensive to ensure shunt infections are not missed. Treatment of an infected shunt involves removal of the shunt followed by a long course of antibiotics; missing or partially treating shunt infections can result in significant morbidity and potentially even mortality. Our experience of managing children with shunts presenting with fever is that many non-specialist clinicians have little experience in this area so initial management may not always be appropriate. Those children who are most at risk of shunt infection are those who within the preceding 8 weeks have had insertion, revision or access of their shunt or chemotherapy device, or have had abdominal surgery in the presence of a ventriculoperitoneal shunt. We have chosen 8 weeks as a pragmatic time point, as in our experience the vast majority of children who have had shunt infections have presented within this period. The caveat is that this should not be used as an absolute cut-off where there is strong suspicion of shunt infection or no clear focus at a later time point.

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Cerebrospinal fluid shunt infections in infants and children in Mobile, Alabama

Cited by 22 publications

References 6 publications

Epidemiology, Prevention and Management of Ventriculoperitoneal Shunt Infections in Children

Epidemiology, Prevention and Management of Ventriculoperitoneal Shunt Infections in Children

The Treatment of Cerebrospinal Fluid Shunt Infections

Fever in a child with cerebrospinal fluid access device or shunt: a pragmatic approach to management

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