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Cerebrospinal Fluid Shunt Infections: A Multicenter Pediatric Study
Alastair McAlpine1, Joan L Robinson2, Michelle Barton3
1From the Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
The Pediatric Infectious Disease Journal
|April 7, 2022
Summary
Staphylococci are the most common cause of cerebrospinal fluid (CSF) shunt infections in children. Antibiotic-resistant Gram-negative bacilli are also a concern, but clinical features do not reliably predict them.
Area of Science:
- Pediatric Infectious Diseases
- Neurosurgery
- Microbiology
Background:
- Cerebrospinal fluid (CSF) shunt infections complicate 5%-10% of shunt placements.
- Understanding contemporary pathogens is crucial for effective treatment.
Purpose of the Study:
- To describe the characteristics and pathogens of CSF shunt infections in children across Canada and the United States.
Main Methods:
- A descriptive case series was conducted.
- Data were collected from 11 tertiary care hospitals between July 2013 and June 2019.
- Included were children up to 18 years of age with CSF shunt infections.
Main Results:
- 154 children experienced CSF shunt infections, with a median time to infection of 54 days post-placement.
- Coagulase-negative staphylococci (28%) and methicillin-susceptible Staphylococcus aureus (16%) were the most common pathogens.
- Antibiotic-resistant Gram-negative bacilli were identified, and empiric antibiotic regimens showed discordance in some cases.
Conclusions:
- Staphylococci continue to be the predominant cause of pediatric CSF shunt infections.
- Antibiotic-resistant Gram-negative bacilli are present but difficult to predict clinically.
- Variability in pathogen distribution and empiric antibiotic choices was noted across institutions.
