[Prevention of infections of cerebrospinal fluid shunts for hydrocephalus]

Two consecutive series of patients operated for insertion or revision of a shunt for hydrocephalus have been followed for at least 18 months. The series are comparable. The first series (84 cases) did not receive antibiotic prophylaxis, whereas the second series (59 cases) received a unique dose of intravenous Vancomycin immediately before the operation. In the first series (168 operations), there were 18 infections, 8 in the group of 34 children and 10 in the group of 50 adults. In the second series, only one infection happened in the group of 27 adults (41 operations) and none among the 22 children (44 operations). The difference was significative. Bacteriological samples were taken during these operations. The positive cultures, mostly for sta. epidermidis, were as frequent among the cases of the first series than among those of the second series. The antibiotics are considered effective in protecting the shunting device against contamination during the surgical procedure by germs from the skin of the patient.