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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Ventriculo-peritoneal shunt infections in infants and children
1Department of Neurosurgery.
Insights
Ventriculoperitoneal (VP) shunt infections are common in Saudi Arabia, with Gram-negative bacteria like Pseudomonas aeruginosa being the primary cause. Early detection and management are crucial for pediatric patients with hydrocephalus.
Area of Science:
- Neurosurgery
- Pediatric Infectious Diseases
- Hospital Epidemiology
Background:
- Ventriculoperitoneal (VP) shunts are vital for managing hydrocephalus in children.
- Shunt infections pose significant risks, leading to increased morbidity and healthcare costs.
- Understanding local infection rates and causative agents is essential for effective prevention and treatment strategies.
Purpose of the Study:
- To determine the incidence and types of ventriculoperitoneal (VP) shunt infections in pediatric patients.
- To identify the most common pathogens responsible for VP shunt infections in the region.
- To compare infection rates with international benchmarks.
Main Methods:
- A retrospective review of VP shunt infection episodes was conducted between mid-2003 and end-2006.
- Cerebrospinal fluid (CSF) samples were analyzed for pathogen identification.
- Treatment involved empirical antibiotics, shunt removal, external ventricular drainage (EVD), and subsequent re-insertion of a new shunt.
Main Results:
- VP shunt infections occurred in 25.9% of patients and 29.3% of procedures.
- Recurrent infections were observed in 40% of infected patients.
- Pseudomonas aeruginosa (50%) and Staphylococcus epidermidis (18.2%) were the most common pathogens, with Gram-negative organisms predominating.
Conclusions:
- The incidence of VP shunt infections at King Fahad Hofuf hospital is high compared to international centers.
- Gram-negative organisms, particularly Pseudomonas aeruginosa, are the leading cause of VP shunt infections in this pediatric population.
- Prompt management involving EVD and targeted antibiotics is critical for sterile CSF and successful shunt revision.
Objective:
To determine the rate and the type of ventriculoperitoneal (VP) shunt infections in infants and children admitted to King Fahad Hofuf hospital of Al-Ahsaa area at the Eastern Province of Saudi Arabia.
Methods:
From mid 2003 to end of 2006; VP shunt infection episodes were reviewed. Once infection was suspected, a cerebrospinal fluid (CSF) sample was taken and empirical antibiotics were recommended. Once infection was confirmed, VP shunt was removed and external ventricular drainage (EVD) was inserted until CSF became sterile after which a new shunt was inserted.
Results:
25.9% of patients with VP shunts had infections which represents 29.3% of the procedures. 40% of infected patients had recurrent episodes. 59.1% of infections occurred throughout the first two months following insertion. Single pathogen was isolated in each episode. Pseudomonas auerginosa represented 50% of isolated pathogens compared with 18.2% with Staphylococcus epidermidis.
Conclusions:
There is a high incidence of VP shunt infections in King Fahad Hofuf hospital when compared with other international centres. Gram negative organisms are the most common cause of the infection.
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