The effect of antibiotic prophylaxis on infection post ventriculo-peritoneal shunting

Abstract

Objective To determine whether antibiotic prophylaxis (AP) can reduce the rate of postoperative infection of ventriculo-peritoneal (V-P) shunting. Methods In this study, we retrospectively analyzed the data of 518 patients who underwent V-P shunting at Department of Neurosurgery, Tianjin Huanhu Hospital from January 2011 to December 2016. According to whether prophylactic antibiotics were administered, all cases were divided into AP group (n=297) and non-AP(n-AP) group (n=221). The rate of infection post shunting was calculated in both groups. The effect of AP on the positive rate of cerebrospinal fluid culture was analyzed. Results There was no significant difference in the infection rate between AP group [6.7% (20/297)] and n-AP group[4.1% (9/221)] (χ2=1.698, P=0.192). There were 20 cases of postoperative infections in AP group, of which 9 were culture-positive, including 7 cases of staphylococcus epidermidis, 1 case of acinetobacter baumannii and 1 case of klebsiella pneumoniae. There were 9 cases of postoperative infections in n-AP group, of which 8 were culture-positive, including 5 cases of staphylococcus epidermidis, 1 case of staphylococcus aureus, 1 case of enterococcus, and 1 case of pseudomonas aeruginosa. There was significant difference in the positive percentage of bacterial culture between the two groups(P=0.026). Conclusions AP seems to be unable to lower the rate of infection post V-P shunting. However, it could reduce the positive rate of bacterial culture. Key words: Antibiotic prophylaxis; Ventriculoperitoneal shunt; Postoperative complications; Central nervous system infections