title: Infectious complications of intrathecal baclofen pump devices in a pediatric population.
abstract: BACKGROUND
  Intrathecal baclofen (ITB) is an effective therapy for spasticity and dystonia in pediatric populations; however, there are associated infectious complications.
  
  
  METHODS
  Patients who had an initial ITB device implanted at our center were followed to determine the proportion of patients with infectious and noninfectious complications, identify risk factors for infection and describe the clinical presentations, treatment and outcomes of infectious complications.
  
  
  RESULTS
  Over the 15-year study period, 139 patients had an initial ITB device placed. The mean age at placement was 13.6 years (range: 6 months to 41 years). In the first year of follow-up, 83% had no complications or secondary procedures, 17% had at least 1 secondary procedure and 5% had an infectious complication. The median time until infection was 14 days (mean 33 ± 42 days). Patients with secondary spasticity or dystonia were more likely to have infections than patients with cerebral palsy (86% versus 14%; P < 0.0001). In the 94 patients with a first secondary procedure, 29% had at least 1 other procedure and 8% had an infection in the 1 year follow-up. Overall, 24 patients had 27 infections; 22% superficial, 33% deep and 45% organ space. Staphylococcus aureus was isolated in 50% of those with cultures obtained. Explantation was required in 59% of patients with an infection and differed by infection type: superficial (17%), deep (44%) and organ space (92%) (P = 0.004).
  
  
  CONCLUSIONS
  Infectious complications were relatively uncommon; however, when present, frequently led to the explantation of the ITB pump device.
authors: Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. michelle.dickey@cchmc.org
authors: Michelle P
authors: MP
authors: Dickey
authors: Marilyn
authors: M
authors: Rice
authors: Douglas G
authors: DG
authors: Kinnett
authors: Robin
authors: R
authors: Lambert
authors: Stephanie
authors: S
authors: Donauer
authors: Michael A
authors: MA
authors: Gerber
authors: Mary Allen
authors: MA
authors: Staat
mesh_terms: D000293:Adolescent; D000328:Adult; D001418:Baclofen / Q000008:administration & dosage*; D055499:Catheter-Related Infections / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007260:Infusion Pumps / Q000009:adverse effects*; D007278:Injections, Spinal / Q000009:adverse effects*; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen