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Haemophilus influenzae and Streptococcus pneumoniae infections in children with cerebrospinal fluid shunts

D B Shurtleff1, J D Loeser, A M Avellino

  • 1Department of Pediatrics, University of Washington, School of Medicine, Seattle, Wash. 98195, USA. david.shurtleff@seattlechildrens.org

Pediatric Neurosurgery
|July 18, 2009
PubMed

Insights

Pediatric patients with cerebrospinal fluid (CSF) shunts face a high risk of Haemophilus influenzae and Streptococcus pneumoniae infections. Healthcare providers should strongly encourage routine infant immunizations and pneumococcal vaccines for these children.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Cerebrospinal fluid (CSF) shunts are crucial for managing hydrocephalus in pediatric patients.
  • Shunt placement can increase the risk of central nervous system (CNS) infections.

Purpose of the Study:

  • To determine the frequency of CNS infections caused by Haemophilus influenzae and Streptococcus pneumoniae in pediatric patients with CSF shunts.
  • To evaluate the necessity of immunizations in this vulnerable patient group.

Main Methods:

  • Retrospective review of prospectively collected data from three computer databases.
  • Analysis of CSF shunt procedures and related infections in pediatric patients without brain tumors.

Main Results:

  • Over a 50-year period (1957-2007), 1,226 patients underwent 3,889 shunt placements.
  • Fourteen episodes of Haemophilus or pneumococcal infections occurred in 12 patients.

Conclusions:

  • Pediatric patients with CSF shunts exhibit a significant risk for Haemophilus influenzae and Streptococcus pneumoniae infections.
  • Routine infant immunizations and the 23-valent polysaccharide pneumococcal vaccine are essential.
  • Healthcare providers should actively promote vaccination and consider expanded-coverage vaccines when available.
Abstract

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