title: Incidence and risk factors of ventriculoperitoneal shunt infections in children: a study of 333 consecutive shunts in 6 years.
abstract: The major aims of this study were to estimate the infection rate and recognize the risk factor for ventriculoperitoneal (VP) shunt infections in children. To analyze shunt infection rate and identify risk factors, a retrospective cohort analysis of 333 consecutive VP shunt series was performed at Seoul National University Children's Hospital in Korea between January 2005 and February 2011. Overall, 35 shunts (10.5%) were infected, which represented an infection rate of 0.075 infection cases per shunt per year. VP shunt infection occurred at a median of 1 month (range, 6 days to 8 months) after insertion. An independent risk factor for shunt infection was undergoing an operation before the first year of life (relative risk 2.31; 95% confidence interval, 1.19-4.48). The most common causative microorganism was coagulase-negative staphylococci in 16 (45.7%) followed by Staphylococcus aureus in 8 (22.9%). Methicillin resistance rate was 83.3% among coagulase-negative staphylococci and S. aureus. In this study, cerebrospinal fluid shunt infection rate was 10.5%. Infection was frequently caused by methicillin-resistant coagulase-negative staphylococci and S. aureus within two months after shunt surgery. Vancomycin may be considered as the preoperative prophylaxis for shunt surgery in a situation where methicillin resistance rate is very high.
authors.affiliation: Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Joon Kee
authors.initials: JK
authors.lastname: Lee
authors.forename: Joon Young
authors.initials: JY
authors.lastname: Seok
authors.forename: Joon Ho
authors.initials: JH
authors.lastname: Lee
authors.forename: Eun Hwa
authors.initials: EH
authors.lastname: Choi
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Phi
authors.forename: Seung-Ki
authors.initials: SK
authors.lastname: Kim
authors.forename: Kyu-Chang
authors.initials: KC
authors.lastname: Wang
authors.forename: Hoan Jong
authors.initials: HJ
authors.lastname: Lee
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D012189:Retrospective Studies; D012307:Risk Factors; D013210:Staphylococcus / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D014640:Vancomycin / Q000627:therapeutic use; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin