title: Antibiotic Reservoir Injection Reduces Shunt Infection in Adults.
abstract: BACKGROUND
  Shunt infections are a major complication following ventricular shunts in adults that lead to increased heath care costs, patient morbidity, and mortality. Methods to decrease shunt infection include antibiotic-impregnated catheters, protocol-based surgery, and shunt reservoir antibiotic injection.
  
  
  METHODS
  An Institutional Review Board-approved retrospective review was performed for all adult shunt surgeries performed from January 2000 to September 2013 at a single academic institution. Records were cross-indexed with hospital billing records to identify patients who received antibiotic injections and cross-referenced with a prospective infection control database of all surgical site infections. The primary outcome measure was shunt infection within 1 year of surgery.
  
  
  RESULTS
  Five-hundred thirteen adult patients met inclusion criteria. Antibiotic reservoir injection was associated with a significantly lower rate of infection (2.6%) when compared with no injection (6.3%, P = 0.0455). The antibiotic injection group also included significantly more patients with infection risk factors than the control group (38.8% vs. 18.0%, P < 0.005).
  
  
  CONCLUSIONS
  Antibiotic reservoir injection is an effective method of reducing shunt infections in adults when combined with standard infection control measures.
authors: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors: Anthony M
authors: AM
authors: Burrows
authors: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors: Meghan E
authors: ME
authors: Murphy
authors: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors: David J
authors: DJ
authors: Daniels
authors: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: Meyer.Fredric@mayo.edu.
authors: Fredric B
authors: FB
authors: Meyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Adults; Antibiotic reservoir injection; Antibiotic-impregnated shunt system; Infection; Ventricular shunts