[Effect of antibiotic-impregnated catheters on the incidence of infection after cerebrospinal fluid shunting].
OBJECTIVE
Infection is a major complication after cerebrospinal fluid (CSF) shunt systems insertion. Antibiotic-impregnated (AI) catheters seem to reduce infection rate in clinical practice. The objective of this study was to determine if the use of AI catheters reduces Staphylococcus spp. infection rate, as it is the most commonly isolated organism.


METHODS
Authors retrospectively reviewed all patients who underwent rifampin-impregnated and clindamycin-impregnated catheters at our hospital. These included external ventricular catheters (inserted from January 2006 to January 2007) and internalized shunts (inserted from January 2004 to January 2007). They also reviewed patients who underwent insertion of non-impregnated external catheters and internalized shunts during the same periods. Overall infection rate, Staphylococcus spp. infection rate and gram negative bacilli infection rate were compared in both groups by means of chi2 test.


RESULTS
Sixty-five procedures with AI catheters and 66 procedures with non-AI catheters were performed. Overall infection rate as well as Staphylococcus spp. infection rate were significantly lower in the AI catheters cohort (p = 0.046 and p = 0.029, respectively), without increasing gram negative bacilli infections.


CONCLUSIONS
The use of rifampin and clindamycin-impregnated catheters is a useful tool to reduce Staphylococcus spp. infections after CSF shunting procedures. However, future clinical trials are required to confirm these results.
Gutiérrez-González
Raquel
R
Servicio de Neurocirugía, Hospital Clínico San Carlos, Madrid, España. rgutierrezgonzalez@yahoo.es
Boto
Gregorio R
GR
González
Nieves
N
Viudez
Isabel
I
Pérez-Zamarrón
Alvaro
A
Rivero-Garvía
Mónica
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
D000900:Anti-Bacterial Agents