Infection of Cerebrospinal Fluid Drainage Devices

Area of Science:

• Microbiology
• Infectious Diseases
• Genomics

Background:

• Ventricular reservoir and cerebrospinal fluid (CSF) shunt infections are traditionally diagnosed via bacterial cultures of CSF.
• High throughput sequencing (HTS) offers a potential method to analyze microbial communities in CSF for infection detection and monitoring.

Purpose of the Study:

• To evaluate HTS for detecting the onset of ventricular reservoir infections.
• To assess HTS utility in monitoring treatment response for CSF shunt infections.

Main Methods:

• Applied HTS targeting the V4 region of the 16S rRNA gene to CSF samples.
• Studied neonates with ventricular reservoirs and children with CSF shunt infections.
• Compared HTS taxonomic results with standard microbiological cultures.

Main Results:

• HTS did not detect a robust signal for responsible bacteria prior to ventricular reservoir infections.
• HTS detected the responsible bacteria genus in 6 of 7 CSF shunt infection cases at the time of positive culture.
• The proportion of sequences from the responsible bacteria genus decreased during CSF shunt infection treatment.

Conclusions:

• HTS has limited utility for surveillance of emerging ventricular reservoir infections due to their abrupt onset.
• HTS can monitor treatment response in CSF shunt infections, showing a return to heterogeneous microbiota as cultures clear.