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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Antibiotic-impregnated ventriculo-peritoneal shunts in patients at high risk of infection
Alessio Albanese1, Pasquale De Bonis, Giovanni Sabatino
1Institute of Neurosurgery, Catholic University School of Medicine, l.go A. Gemelli, 8, 00168 Rome, Italy.
Insights
Antibiotic-impregnated shunts (AIS) show promise in preventing shunt infections in high-risk patients. No infections occurred in the AIS group, compared to 58.3% in the non-AIS group, suggesting AIS efficacy.
Area of Science:
- Neurosurgery
- Infectious Disease
Background:
- Shunt infections are a significant complication in hydrocephalus treatment.
- Patients with severe disabilities and frequent nosocomial infections represent a high-risk group for shunt complications.
Purpose of the Study:
- To evaluate the effectiveness of antibiotic-impregnated shunts (AIS) in reducing the incidence of shunt infections.
- To assess AIS efficacy in a specific high-risk patient population.
Main Methods:
- A retrospective study was conducted from October 2005 to October 2007.
- Eighteen high-risk adult patients undergoing shunt placement were identified.
- Six patients received AIS, while 12 received non-AIS.
Main Results:
- No shunt infections were observed in the AIS group (0%).
- The non-AIS group experienced a shunt infection rate of 58.3% (7 out of 12 patients).
- Infections in the non-AIS group predominantly occurred within six months post-surgery, with a prevalence of S. epidermidis.
Conclusions:
- Antibiotic-impregnated shunts (AIS) may be effective in preventing infections in high-risk patients.
- Further large-scale, prospective studies are warranted to confirm these findings definitively.
Purpose:
To determine the efficacy of antibiotic impregnated shunts (AIS) in reducing shunt infections in a population at high risk of shunt infection.
Methods:
From October 2005 to October 2007, patients at high risk of infection (severely disabled, not able to take care of themselves, frequent nosocomial infections) were selected from the 198 adults who underwent shunt placement.
Results:
Eighteen adults were identified (mean age 61.8 years). Six patients had AISs, and 12 patients had non-AISs. Groups did not differ in age, sex, type of hydrocephalus or hospital stay before shunting. Shunt infection occurred in 7/12 cases of the non-AIS group (58.3%) versus no infections in the AIS group. In six of seven cases, infection occurred within the first 6 months after surgery. A prevalence of S. epidermidis was detected.
Conclusions:
We believe that in these patients AIS could be effective. Larger, prospective studies are needed in order to definitely address this issue.
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