Skip to main content
Log in

Cerebrospinal fluid shunt infections in infants

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Infection remains a major cause of morbidity and mortality following CSF shunt procedures. In this study 191 shunt procedures carried out from January 1981 to December 1992 in a series of 81 infants (less than 6 months old) were retrospectively analyzed for possible risk factors. The overall surgical infection rate was 7.8%, with 15 infections occurring in 14 patients (17.2%). No significant difference in the rate of infections was found in relation to sex, birth weight, gestational age, and type of shunt procedure (primary insertion/revision). The occurrence of other infections during the period of shunt surgery did not influence the infection risk either. Intraventricular hemorrhage and central nervous system infections as causes of the hydrocephalus were found to correlate with septic risk. Young age (less than 6 months) seems to represent the main risk factor, and this is related both to the immunologic deficiency and to the particular features of residential bacterial flora in this age group.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Agabiti N, Caldarelli M, Di Rocco C, Marietti G, Paone FM (1988) Ventriculiti cerebrali in età pediatrica. Minerva Pediatr 40:1–14

    Google Scholar 

  2. amacher AL, Wellington J (1984) Infantile hydrocephalus: long-term results of surgical therapy. Child's Brain 11:217–229

    Google Scholar 

  3. Bayston R, Rodgers J (1990) Production of extra-cellular slime by Staphylococcus epidermidis during stationary phase of growth: its association with adherence to implantable devices. J Clin Pathol 43:866–870

    Google Scholar 

  4. Bayston R, Bannister C, Boston V, Burman R, Burns B, Cooke F, Cudmore R, Fitzgerald R, Goldberg C, Green HT, Guiney E, Hardwidge C, Hart CA, Holmes AE, Meigh J, Rampling A, Walker J, Webb H, Whale K (1990) A prospective randomised controlled trial of antimicrobial prophylaxis in hydrocephalus shunt surgery. Z Kinderchir 45:5–7

    Google Scholar 

  5. Bierbrauer KS, Storr BB, McLone DG Tadanori T, Dauser R (1990–1991) A prospective, randomized study of shunt function and infections as a function of shunt placement. Pediatr Neurosurg 16:287–291

    Google Scholar 

  6. Choux M, Genitori L, Lang D, Lena G (1992) Shunt implantation: reducing the incidence of shunt infection. J Neurosurg 77:875–880

    Google Scholar 

  7. D'Angiò CT, McGowan KL, Baumgart S, Geme JS, Harris MC (1989) Surface colonization with coagulase-negative staphylococci in premature neonates. J Pediatr 114:1029–1034

    Google Scholar 

  8. Diaz-Mitoma F, Harding GK, Hoban DJ, Roberts RS (1987) Clinical significance of a test of slime productor in ventriculo-peritoneal shunt infections caused by coagulase negative staphylococci. J Infect Dis 156:555–560

    Google Scholar 

  9. Elek SD, Conen PE (1957) Virulence of Staphylococcus pyrogenes for man. A study of the problems of wound infection. Br J Exp Pathol 38:573–586

    Google Scholar 

  10. Gaskill SJ, Marlin AE (1989) Pseudocysts of the abdomen associated with ventriculoperitoneal shunts: a report of twelve cases and a review of the literature. Pediatr Neurosci 15:23–27

    Google Scholar 

  11. Haines S (1986) Antibiotic prophylaxis in neurosurgery. Clin Neurosurg 33:633–642

    Google Scholar 

  12. Haines S, Taylor F (1982) Prophylactic methicillin for shunt operations: effects on incidence of shunt malfunction and infection. Child's Brain 9:10–22

    Google Scholar 

  13. Kontny U, Heofling B, Gutjahr P, Voth D, Schwarz M, Schmitt HJ (1993) CSF shunt infections in children. Infection 21:89–93

    Google Scholar 

  14. Leyden JJ, McGinley KJ, Mills OH, Kligman AM (1975) Age-related changes in the resident bacterial flora of the human face. J Invest Dermatol 65:379–381

    Google Scholar 

  15. Nelson WE (1992) Nelson textbook of pediatrics, 14th edn, Behrman, Philadelphia, pp 739–744

    Google Scholar 

  16. Odio C, McCracken HG, Nelson JD (1984) CSF shunt infections in pediatrics. Am J Dis Child 138:1103–1108

    Google Scholar 

  17. Pople IK, Bayston R, Hayward RD (1992) Infection of cerebrospinal fluid shunts in infants: a study of etiological factors. J Neurosurg 77:29–35

    Google Scholar 

  18. Quigley RM, Reigel HD, Kortyna R (1989) Cerebrospinal fluid shunt infections. Pediatr Neurosci 15:111–120

    Google Scholar 

  19. Raahave D, Friis-Moeller A, Bjere-Jepsen K, Thiis-Knudsen J, Rasmussen LB (1986) The infective dose of aerobic and anaerobic bacteria in postoperative wound spesis. Arch Surg 121:924–929

    Google Scholar 

  20. Raimondi AJ, Robinson JS, Kuwamura K (1977) Complications of ventriculoperitoneal shunter and a critical comparison of the three-piece and onepiece systems. Child's Brain 3:321–342

    Google Scholar 

  21. Renier D, Lacombe J, Pierre-Kahn A, Sainte-Rose C, Hirsch J (1984) Factors causing acute shunt infection: computer analysis of 1174 operations. J Neurosurg 61:1072–1078

    Google Scholar 

  22. Sarkany I, Gaylarde CC (1967) Skin flora of the newborn. Lancet 1:589–590

    Google Scholar 

  23. Serlo W, Fernell E, Heikkinen E, Anderson H, Wendt L von (1990) Functions and complications of shunts in different etiologies of childhood hydrocephalus. Child's Nerv Syst 6:92–94

    Google Scholar 

  24. Shapiro S, Boaz J, Kleimas M, Kalsbeck J, Mealey J (1988) Origin of organisms infecting ventricular shunts. Neurosurgery 22:868–872

    Google Scholar 

  25. Shurleff DB, Stuntz TJ, Hayden PW (1985–86) Experience with 1201 cerebrospinal fluid shunt procedures. Pediatr Neurosci 12:49–57

    Google Scholar 

  26. Stein CS (1987) Management of infected CSF shunts in infants and children. Contemp Neurosurg 1:1–6

    Google Scholar 

  27. Vinchon M, Vallee L, Prin L, Desreumaux P, Dhellemmes P (1992) Cerebro-spinal fluid eosinophilia in shunt infections. Neuropediatrics 23:235–240

    Google Scholar 

  28. Walsh AR, Dollo C, Hawyard RD, Grant DN (1989) Shunt infections in infants and children following primary shunt insertion. J Pediatr Neurosci 5:235–240

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dallacasa, P., Dappozzo, A., Galassi, E. et al. Cerebrospinal fluid shunt infections in infants. Child's Nerv Syst 11, 643–649 (1995). https://doi.org/10.1007/BF00300722

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00300722

Key words

Navigation