Prevention and management of internal cerebrospinal fluid shunt infections.
Cerebrospinal fluid (CSF) shunt infection is a serious and potentially devastating complication of CSF shunt placement. Younger age, previous CSF shunt infection or revision, and the type of the shunt are important risk factors for shunt infection. More than half of the cases are caused by Staphylococcus aureus and coagulase-negative staphylococci. The biofilm plays a central role in its pathogenesis. CSF cultures remain the gold standard for diagnosis of CSF shunt infection. The most effective way to prevent CSF shunt infection is optimization of sterile protocols and use of proper and timely antibiotic prophylaxis. Management of CSF shunt infection frequently requires removal of all shunt components, placement of a temporary external device, and administration of intravenous antibiotics, followed by reshunting at a later time. This review summarizes and analyses the results of previous reports of CSF shunt infection and assesses the prevention and management of this important entity.
Department of Neurology, University of Arizona, Tucson, AZ, USA. Electronic address: judydawod@yahoo.com.
J
J
Dawod
Department of Medicine, University of Arizona, Tucson, AZ, USA.
A
A
Tager
Section of Infectious Diseases, Department of Medicine, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, USA.
R O
RO
Darouiche
Department of Medicine, University of Arizona, Tucson, AZ, USA.
M
M
Al Mohajer
D019072:Antibiotic Prophylaxis / Q000379:methods; D019090:Case Management; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008828:Microbiological Techniques / Q000379:methods; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy*
Cerebrospinal fluid shunt; Infection; Management; Prevention; Ventriculo-peritoneal