Ventriculoperitoneal shunt infections in children; 10 years of experience in a single center

Abstract

Objective: Shunt infections are a serious health problem seen in children. Our aim in this study is to investigate the clinical features, bacterial pathogens and antimicrobial treatments of pediatric patients with ventriculoperitoneal shunt infection.
 Methods: This retrospective study included 108 pediatric patients with ventriculoperitoneal shunt infection who were followed up in the Pediatric Infection Clinic of Dicle University Medical Faculty between January 2019 and December 2019.
 Results: The cases were 48.1% male and 51.9% female. Ventriculoperitoneal were placed in 70.4% of the cases when they were 0-1 months old, and in 15.7% of the cases when they were 2-3 months old. The most common cause of ventriculoperitoneal shunt implantation was congenital hydrocephalus (90.7%), followed by central nervous system tumors (5.6%) and central nervous system infections (2.8%). The most common clinical signs and symptoms were fever (91.7%), vomiting (87%), convulsion (49.1%), change of consciousness (50.9%), meninx irritation finding (37.0%), anterior fontanelle cuff (65.7%), shunt leak (57.4%) and abdominal symptoms (62%). The most frequently isolated pathogens from cerebrospinal fluid cultures were Coagulase negative staphylococcus (36.1%), Staphylococcus aureus (14.8%), Klebsiella pneumoniae (13%), Pseudomonas aeruginosa (6.5%), Acinetobacter baumannii (16%,) and Escherichia coli (11.1%). The most commonly used antibiotics in treatments were vancomycin (68.5%), meropenem (67.5%), ceftriaxone (45.3%), colimycin (26.8%), amikacin (25%), linezolid (21.2%) and cephotaxime (9.2%). The mortality rate of the patients was 20.4%.
 Conclusions: Knowing the risk factors and taking early precautions in ventriculoperitoneal shunt infections can significantly reduce shunt infections, and better results can be obtained by determining the possible pathogens and starting empirical treatment accordingly.