Reflections on shunt infection

被引:92
作者
Kanev, PM
Sheehan, JM
机构
[1] Penn State Univ, Milton S Hershey Med Ctr, Dept Neurol, Hershey, PA 17033 USA
[2] Penn State Univ, Sch Med, Dept Neurosurg, Hershey, PA 17033 USA
关键词
shunt infection; hydrocephalus; ventriculoperitoneal shunt;
D O I
10.1159/000075255
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The placement and revision of ventriculoperitoneal (VP) shunts remains a mainstay in the surgical treatment of hydrocephalus. While the North American infection rate averages nearly 8 - 10%, published infection rates for VP shunt infection below 1% have been reported. We retrospectively reviewed shunt operations by a single surgeon over 62 months to analyze the infection rate. In 62 months, we performed 526 shunt placements or revisions in patients up to 18 years of age. There were 7 shunt infections (1.33%). In 5 cases, the organism was Staphylococcus epidermidis, and a single shunt each was infected with Haemophilus influenzae and Staphylococcus aureus. Each infection was treated with external ventriculostomy drainage and intravenous antibiotics. The new shunt was placed at a new incision site after at least 5 days of sterile spinal fluid cultures. The mean follow-up among these patients after shunt insertion was 25 months. VP shunting remains the most common operation for hydrocephalus. Infections are linked with seizures, higher future risks of shunt infection and malfunction, and reduced IQ and school performance. Our infection rate during 62 months was limited to 1.33%. Uniform surgical technique, limited hardware and skin edge manipulation and double gloving may be important factors in limiting shunt infections. Copyright (C) 2003 S. Karger AG, Basel.
引用
收藏
页码:285 / 290
页数:6
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