Risk factors for pediatric ventriculoperitoneal shunt infection and predictors of infectious pathogens.
Identification of risk factors for shunt infection and predictors of infectious pathogens may improve current methods to prevent and treat shunt infections. We reviewed data on 820 consecutive ventriculoperitoneal (VP) shunt placement procedures in 442 pediatric patients at our institution during 1992-1998. Ninety-two shunts (11%) developed infection a median of 19 days (interquartile range, 11-35 days) after insertion. Premature birth (relative risk [RR], 4.81; 95% confidence interval [CI], 2.19-10.87), previous shunt infection (RR, 3.83; 95% CI, 2.40-6.13), and intraoperative use of the neuroendoscope (RR, 1.58; 95% CI, 1.01-2.50) were independent risk factors for shunt infection. The bacterial organisms early after shunt surgery (<14 days) were the same as those late after shunt surgery (>14 days). As determined by an analysis of the 92 infected shunts, hospital stay of >3 days at the time of shunt insertion (odds ratio [OR], 5.27; 95% CI, 1.15-25.3) and prior Staphylococcus aureus shunt infection (OR, 5.91; 95% CI, 1.35-25.9) independently increased the odds that S. aureus was the causal pathogen.
McGirt
Matthew J
MJ
Division of Infectious Disease, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
Zaas
Aimee
A
Fuchs
Herbert E
HE
George
Timothy M
TM
Kaye
Keith
K
Sexton
Daniel J
DJ
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000382:microbiology*; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013211:Staphylococcus aureus; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*