THERAPY OF STAPHYLOCOCCUS EPIDERMIDIS: INFECTIONS ASSOCIATED WITH CEREBROSPINAL FLUID SHUNTS

Abstract

This study describes cure rates for 93 different courses of treatment for 28 hydrocephalic patients with V-A shunts and 31 separate infections due to Staphylococcus epidermidis. Systemic treatment alone was effective two out of 39 times (9%). The addition of antibiotics via the intraventricular route (with or without partial shunt revision) cured three with nine trials (33%). All 19 patients, 18 with positive cerebrospinal fluid (CSF) cultures, were cured by complete removal of all shunt elements with replacement in another anatomic site (CSR) combined with high does, specific systemic antibiotic therapy. One of 35 (3%) of those with positive shunt CSF cultures and one of 21 (5%) of those with positive shunt and ventricular CSF cultures responded to systemic treatment without CSR. When infection is widespread, the treatment of choice is appropriate systemic and intraventricular antibiotics and complete replacement of the shunt in a new site.