title: How frequently external ventricular drainage device should be changed in children with ventriculoperitonel shunt infection?
abstract: OBJECTIVE
  The purpose of the presenting study was to determine how frequently external ventricular drainage (EVD) device should be changed in children with ventriculopertienal shunt (VPS) infection during prolonged intravenous antimicrobial therapy.
  
  
  METHODS
  In this retrospective study, 25 children with VPS infection were evaluated between January 2012 and December 2013. In these children VPS was surgically removed and appropriate antimicrobial therapy was administered according to cerebrospinal culture results. Data noted about how frequently EVD device had been changed, the number of cells on direct observation of cerebrospinal fluid (CSF), glucose and protein levels of CSF, and CSF culture results were obtained from patients' records.
  
  
  RESULTS
  Total 25 children were included in the study. The median age was three months (1 and 65 months). In 44% of children, Staphylococcus epidermidis was isolated. During treatment period, EVD catheter has changed one to six times. A total of 68 EVD catheters were changed in these patients. When the duration of ventriculostomy catheter and leukocyte count in CSF were evaluated on daily basis, leukocyte count was decreased 5 units per day in children whose catheter remained less than 10 days. However, in children whose catheter remained more than 10 days leukocyte count was decreased 2.21 units per day.
  
  
  CONCLUSIONS
  In children with VPS infection, EVD device should be changed at every 10 days for the rapid resolution of the infection.
authors.affiliation: Ismail Gulsen, Department of Neurosurgery, Yuzuncu Yil University, School of Medicine, Van, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Gulsen
authors.affiliation: Hakan Ak, Department of Neurosurgery, Bozok University, School of Medicine,Yozgat, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Ak
authors.affiliation: Nihat Demir, Department of Pediatrics, Yuzuncu Yil University, School of Medicine, Van, Turkey.
authors.forename: Nihat
authors.initials: N
authors.lastname: Demir
authors.affiliation: Enver Sosuncu, Department of Neurosurgery, Yuzuncu Yil University, School of Medicine, Van, Turkey.
authors.forename: Enver
authors.initials: E
authors.lastname: Sosuncu
authors.affiliation: Mehmet Arslan, Department of Neurosurgery, Yuzuncu Yil University, School of Medicine, Van, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Arslan
keywords: External ventricular drainage; Hydrocephalus; Ventriculoperitoneal shunt infection