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Updated: Feb 15, 2026

A Choroid Plexus Epithelial Cell-based Model of the Human Blood-Cerebrospinal Fluid Barrier to Study Bacterial Infection from the Basolateral Side
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A Choroid Plexus Epithelial Cell-based Model of the Human Blood-Cerebrospinal Fluid Barrier to Study Bacterial Infection from the Basolateral Side

Published on: May 6, 2016

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Topical vancomycin reduces the cerebrospinal fluid shunt infection rate: A retrospective cohort study

Erik J van Lindert1, Martine van Bilsen1, Michiel van der Flier2

  • 1Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands.

Plos One
|January 10, 2018
PubMed
Abstract

Insights

Adding topical vancomycin to cerebrospinal fluid (CSF) shunt surgery significantly reduced infection rates. This intervention lowered the risk of CSF shunt infections in patients, improving surgical outcomes.

Area of Science:

  • Neurosurgery
  • Infectious Disease Prevention
  • Pharmacology

Background:

  • Cerebrospinal fluid (CSF) shunt infections are a significant complication in shunt surgery, occurring in 5-15% of cases.
  • Efforts to reduce shunt infection rates are crucial for improving patient outcomes and reducing morbidity.

Purpose of the Study:

  • To evaluate the effectiveness of adding topical vancomycin to an existing shunt infection prevention protocol.
  • To determine if topical vancomycin reduces the incidence of CSF shunt infections.

Main Methods:

  • A retrospective cohort study compared patients who underwent shunt surgery before (control group, 263 procedures) and after (intervention group, 499 procedures) the addition of topical vancomycin.
  • Topical vancomycin was administered both intrashunt and perishunt starting in April 2012.

Main Results:

  • The overall shunt infection rate decreased significantly from 6.8% in the control group to 3.0% in the intervention group (p = 0.023).
  • Multivariate analysis confirmed that topical vancomycin was associated with a decreased shunt infection rate (OR 0.49, p = 0.049).
  • Younger age (<1 year) was a significant risk factor for infection (OR 4.41, p = 0.001), and time to infection was prolonged in the vancomycin group (p = 0.001).

Conclusions:

  • Intraoperative topical vancomycin significantly reduces the rate of cerebrospinal fluid shunt infections.
  • The addition of vancomycin to prophylaxis protocols is an effective strategy for preventing shunt infections.

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