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Updated: Oct 11, 2025
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Intraventricular Vancomycin Treatment for Shunt-related Ventriculitis Caused by Methicillin-resistant Staphylococcus
Einar A Helgason1, Thorunn Oskarsdottir2, Hrolfur Brynjarsson1
1From the Children's Hospital Iceland, Reykjavík, Iceland.
Insights
A premature neonate with a ventriculoperitoneal shunt infection (methicillin-resistant Staphylococcus aureus) was successfully treated with intraventricular vancomycin when intravenous therapy failed. This case suggests intraventricular vancomycin is a viable treatment option for neonates, advocating for guideline development.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Neurosurgery
Background:
- Posthemorragic hydrocephalus is common in premature infants, often necessitating ventriculoperitoneal shunts.
- Ventriculoperitoneal shunt infections, particularly by methicillin-resistant Staphylococcus aureus (MRSA), pose significant challenges in neonates.
Observation:
- A premature neonate presented with a ventriculoperitoneal shunt infection caused by MRSA.
- Conventional intravenous antibiotic treatment proved ineffective in eradicating the infection.
Findings:
- Intraventricular vancomycin was administered, drawing on available data and expert consultation due to a lack of established guidelines.
- The intraventricular vancomycin treatment successfully eradicated the MRSA infection without any discernible toxicity in the neonate.
Implications:
- This case demonstrates the potential efficacy and safety of intraventricular vancomycin for treating neonatal ventriculoperitoneal shunt infections.
- The findings underscore the critical need for developing international clinical guidelines for intraventricular antibiotic therapy in neonates.
Abstract:
Posthemorragic hydrocephalus is a relatively common condition in prematures, often requiring ventriculoperitoneal shunts. We report a case of methicillin-resistant Staphylococcus aureus infection of a ventriculoperitoneal shunt in a premature neonate which failed conventional intravenous treatment. Despite the absence of published guidelines, we used available data and expert advice to treat the patient with intraventricular vancomycin. The treatment was successful in eradicating the infection without observed toxicity. This case highlights the need for international guidelines on intraventricular treatment for neonates.
