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Updated: Apr 24, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Audit of ventriculoperitoneal shunt infections in paediatric patients, 2006-2013
Emily Mullan1, Carol Lucas2, Sarah Mackie3
1Paediatric Trainee Doctor, Department of Paediatric Surgery, Royal Hospital for Sick Children, UK mullanemily@gmail.com.
Background:
Infection following ventriculoperitoneal shunt placement remains a significant complication with an incidence of 3-27% cited in literature. Infections cause significant morbidity, and it is important that empirical antibiotic therapy for management is guided by accurate knowledge of prevailing aetiologies and local antibiotic sensitivity patterns.
Aims:
To establish the incidence of shunt infections in our paediatric population, to identify the causative micro-organisms, and to determine the antibiotic resistance patterns of the responsible micro-organisms.
Methods:
Retrospective data collection utilising existing databases in the Royal Hospital for Sick Children, Yorkhill, between 1 January 2006 and 30 September 2013.
Results:
Total number of shunt operations was 308 with 28 episodes of infection involving 27 patients (male = 12, female = 15). The incidence of infection was 9%. In all, 79% of the episodes involved a single pathogen with 21% being mixed pathogens. Coagulase-negative staphylococci were the most common cause of infection (44%). Gram-positive sensitivity to flucloxacillin and gentamicin was noticeably low at 22% and 14%, respectively with 87% of coagulase-negative staphylococci resistant to gentamicin and 81% resistant to flucloxacillin.
Conclusions:
The changing spectrum of Gram-positive organisms has impacted on antibiotic sensitivity patterns, and our local prescribing policy has been adapted in order to manage shunt infections most effectively.
Insights
Ventriculoperitoneal shunt infections occur in 9% of pediatric patients, with coagulase-negative staphylococci being the most common cause. Low sensitivity to flucloxacillin and gentamicin necessitates updated antibiotic prescribing policies for effective management.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Microbiology
Background:
- Ventriculoperitoneal shunt placement is prone to infection, a significant complication with reported incidences ranging from 3-27%.
- Shunt infections lead to considerable patient morbidity, underscoring the need for informed empirical antibiotic therapy.
- Understanding local etiological patterns and antibiotic sensitivities is crucial for effective infection management.
Purpose of the Study:
- To determine the incidence of shunt infections in a pediatric population.
- To identify the specific microorganisms responsible for these infections.
- To analyze the antibiotic resistance patterns of the identified causative agents.
Main Methods:
- A retrospective data analysis was conducted.
- Data were collected from existing databases at the Royal Hospital for Sick Children, Yorkhill.
- The study period spanned from January 1, 2006, to September 30, 2013.
Main Results:
- A total of 308 shunt operations were performed, resulting in 28 infection episodes in 27 patients.
- The overall incidence of shunt infection was 9%.
- Coagulase-negative staphylococci were the predominant pathogen (44%), with notably low Gram-positive sensitivity to flucloxacillin (22%) and gentamicin (14%). High resistance rates were observed for coagulase-negative staphylococci against gentamicin (87%) and flucloxacillin (81%).
Conclusions:
- The evolving landscape of Gram-positive organisms has significantly influenced antibiotic sensitivity.
- Local antibiotic prescribing policies have been revised to enhance the management of shunt infections.
- These findings highlight the importance of continuous monitoring of microbial resistance patterns.
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