Cerebrospinal Fluid System Infection in Children with Cancer: A Retrospective Analysis over 14 Years in a Major European Pediatric Cancer Center

Abstract

Infection of a cerebrospinal fluid system is a serious medical complication. We performed a retrospective monocentric analysis on temporary and permanent cerebrospinal fluid devices in children with and without cancer, covering a period of over 14 years. Between 2004 and 2017, 275 children with a cerebrospinal fluid system were seen at our institution. Thirty-eight children suffered from 51 microbiologically proven infectious episodes of the cerebrospinal fluid system (12 children with cancer and 26 children without cancer). Independently of the cerebrospinal fluid system used, the incidence of infection did not significantly differ between children with and without cancer and was the highest in children younger than one year. Infection occurred earlier in external ventricular drain (EVD) than ventriculoperitoneal (VP) shunt, and in EVD significantly earlier in children with cancer compared with patients without cancer. The pathogens isolated were mainly Gram-positive bacteria, in particular Staphylococcus spp., which should be taken into account for empirical antimicrobial therapy.

Alternative Antimicrobial Irrigation Strategies for the Treatment of Infections in Children: A Review of the Existing Literature

“…Also named nosocomial central nervous system (CNS) infections, they can occur following severe craniocerebral trauma, neurosurgery, or intrathecal administration of cytotoxic drugs (i.e., intrathecal infusion pumps) and in patients with foreign body devices (i.e., internal and external cerebrospinal fluid shunts or drains). Moreover, prematurity, low birth weight (<2000 g), underlying diseases requiring invasive medical procedures (i.e., therapeutic lumbar puncture), and nosocomial bacteriemia are predisposing factors for the onset of HA ventriculitis and meningitis [ 8 , 9 ].…”