Cerebrospinal fluid shunt infections in children

Ronan, Anne; Hogg, Geoffrey G; Klug, Geoffrey L.

doi:10.1097/00006454-199509000-00010

Cited by 82 publications

(58 citation statements)

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“…Ronan et al 30 advertem que o exame de LCR pode apresentar-se normal à microscopia e bioquímica e a infecção ser confirmada somente através da cultura. No nosso estudo, o LCR só foi colhido em 50,0% (29/58) dos procedimentos o que não permitiu excluir contaminação pré-operató-ria nos demais casos.…”

Section: Resultsunclassified

Infecções em dispositivos neurológicos implantáveis em crianças e adolescentes

Lima

Pereira

Silva

2007

Arq. Neuro-Psiquiatr.

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RESUMO -Objetivo: Determinar a freqüência, as causas, o sítio específico e as manifestações clínicas e laboratoriais das infecções em crianças e adolescentes após a implantação de dispositivos neurológicos (DVP) no Hospital Governador João Alves Filho (Aracaju SE). Método: Estudo prospectivo, observacional, não controlado de 50 pacientes, submetidos a DVP (58 procedimentos), no período de janeiro de 2003 a outubro de 2004. Resultados: Observaram-se taxas de infecção por procedimento de 27,6%, taxas de infecção de índice cirúrgico zero, 1 e 2 de 25,7% e 30,4%, respectivamente (NNIS-CDC). A infecção de sítio cirúrgico foi a principal complicação com 50% das infecções. Conclusão: Taxa de infecção por procedimento, paciente e índice de risco cirúrgico mostraram-se elevadas. Não houve significância estatística com relação à idade, etiologia da hidrocefalia, ao tipo de procedimento (derivação primária e reinserção), tempo de internação pré-operatória, duração da cirurgia, antibioticoprofilaxia, cateter SNC prévio e índice de risco cirúrgico.PALAVRAS-CHAVE: hidrocefalia, derivação ventrículoperitoneal, infecção em sistema de derivação ventrículo-peritoneal. Ventriculoperitoneal shunt infections in children and adolescents with hydrocephalusABSTRACT -Objective: To determine frequency, etiology, site and clinical and laboratory findings of ventriculoperitoneal shunt (VPS) infections in children and adolescents with hydrocephalus managed in Hospital Governador João Alves Filho, Aracaju SE, Brazil. Method: A non-controlled prospective observational study comprising 50 patients that underwent VPS (58 procedures) from January/2003 to October/2004. Results: Infection rate per procedure was 27.6%; surgical risk index (NNISS-CDC) 0 and 1-2 were 25.7% and 30.4% respectively; surgical site infection was the main complication with 50% of the cases. Conclusion: Infection rates per procedure, per patient, and per surgical risk index were high. No statistical differences were found related to the following: age, etiology of hydrocephalus, type of procedure, pre-operative length of stay, duration of procedure, antibiotic prophylaxis, previous central nervous system catheter, and surgical risk index.

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Section: Resultsunclassified

Infecções em dispositivos neurológicos implantáveis em crianças e adolescentes

Lima

Pereira

Silva

2007

Arq. Neuro-Psiquiatr.

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“…The most susceptible group of patients for VP shunt infections is the pediatric population. Infection rates of up to 15% in children of less than 6 months of age have been reported (3,4). The infection can be treated conservatively with antibiotics, but often requires removal of the shunt.…”

Section: Discussionmentioning

confidence: 99%

“…Prematurity is also a risk factor for VP shunt infections. Premature children with a birth weight of less than 1000 g have the maximum rate of infection; the rate of shunt infection in this group of patients is 71% (4).…”

Section: Introductionmentioning

confidence: 90%

“…Shunt infections among small children and lowbirth-weight and premature infants may occur at higher percentages than in older children. In the relevant literature, reported infection rates range from 3% to 27% among children implanted with a VP shunt before the age of 6 months (3,4). Prematurity is also a risk factor for VP shunt infections.…”

Section: Introductionmentioning

confidence: 99%

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The impact of antibiotic-impregnated catheters on ventriculoperitoneal shunt infection

Sorar¹,

Er²,

Özişik³

et al. 2014

Turk J Med Sci

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Previous studies on in vitro rooting for improved micropropagation of eucalypts indicated that root graviperception and postacclimatisation architecture are determined by the relative exogenous auxin analogue and its stability, supplied during the pre-rooting culture stages. The specific roles of indole-3-acetic acid (IAA) and indole-3-butyric acid (IBA) in the rooting medium on the in vitro root morphological processes were explored using a good-rooting clone. In vitro rooting percentage was significantly reduced when either of the auxin inhibitors 2,3,5-triiodobenzoic acid (TIBA) and ρ-chlorophenoxyisobutyric acid (PCIB) or the auxin antagonist kinetin was supplied at rooting, with or without exogenous auxin. For all treatments, at the time of root induction, shoots did not possess a vascular cambium, only procambial tissue, from where adventitious roots formed. However, when the inhibitors or the antagonist were supplied to the roots 3 days after root induction, they affected root growth and graviperception. Kinetin and PCIB significantly reduced the mean root diameter from 552.8 µm (control) to 129.2 µm and 278.6 µm, respectively, over 3 weeks. While the PCIB treatment resulted in a significant increase in Δ root length over this period, the TIBA treatment significantly decreased ∆ root length and increased mean root diameter to 833.4 µm. Restricting IAA transport with TIBA further altered root vascular patterning and, as with PCIB, resulted in the collapse of the columella region. Nevertheless, only a disruption in IAA transport and subsequent auxin distribution by TIBA treatment resulted in altered root graviperception. The results suggest the necessary inclusion of IAA in eucalypt micropropagation protocols to ensure good quality roots.

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“…Although the incidence of post-operative CSF shunt infections varies considerably among centers, ranging from 1% to 39%, 1 most report infection rates of about 5%. 2 The most common causative pathogens include Staphylococcus epidermidis and Staphylococcus aureus. Recently, the emergence of methicillin-resistant strains of Staphylococcus has made vancomycin the antibiotic of choice for this infection.…”

Section: Introductionmentioning

confidence: 99%

Intraventricular Vancomycin In Pediatric Patients With Cerebrospinal Fluid Shunt Infections

Al-Jeraisy¹,

Phelps

Christensen

et al. 2004

The Journal of Pediatric Pharmacology and Therapeutics

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OBJECTIVESTo determine: 1) the range and magnitude of vancomycin trough cerebrospinal fluid (CSF) concentrations following intraventricular (IVT) vancomycin; 2) any correlation between patient demographic and CSF vancomycin concentrations; and 3) eradication and complications rates following IVT vancomycin. METHODS Medical records of pediatric patients with shunt infection who received IVT vancomycin during a 12 month period were reviewed. Demographic, microbiological data, IVT/intravenous (IV) vancomycin dosing, concomitant antibiotics, CSF and serum vancomycin concentrations, and CSF drainage output were recorded. RESULTS Seventeen patients ages 4 months to 17 years were hospitalized for shunt infection. Staphylococcus epidermidis (n=12) was the predominant organism. Sixteen patients received 10 mg, and one patient received 5 mg of IVT vancomycin for 3-23 days. All but one received concurrent IV vancomycin. The mean maximum trough CSF vancomycin concentration noted for 16 patients who recieved 10 mg of IVT vancomycin was 18.4±21.8 µg/mL (range: between 0.4 to 187.3 µg/mL). All four adolescents ≥25 kg had CSF vancomycin concentrations ≤5 µg/mL, three of four infants/ children between 10.1 and 24.9 kg had trough CSF vancomycin concentrations between 10-20 µg/ mL, and five of nine infants <10 kg had CSF concentrations >20 µg/mL. All organisms were successfully eradicated. One patient developed chronic eosinophilia presumed related to elevated CSF vancomycin concentrations (187 µg/mL). CONCLUSIONS -The combination of IVT and IV vancomycin effectively eradicated CSF shunt infections. CSF vancomycin concentrations are highly variable and poorly correlated with age and CSF output. Following a 10 mg IVT vancomycin dose, CSF concentrations appear to be lower in older children and elevated in infants/young children. One infant experienced a complication related to an elevated CSF vancomycin concentration; hence, therapy must be individualized, using CSF trough vancomycin concentrations.

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Cerebrospinal fluid shunt infections in children

Cited by 82 publications

References 0 publications

Infecções em dispositivos neurológicos implantáveis em crianças e adolescentes

Infecções em dispositivos neurológicos implantáveis em crianças e adolescentes

The impact of antibiotic-impregnated catheters on ventriculoperitoneal shunt infection

Intraventricular Vancomycin In Pediatric Patients With Cerebrospinal Fluid Shunt Infections

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