title: Hydrogel-coated ventricular catheters for high-risk patients receiving ventricular peritoneum shunt.
abstract: Shunt infection is a morbid complication of cerebrospinal fluid (CSF) shunting. The catheters with a hydrophilic surface may impede bacterial adherence and thereby reduce catheter-related CSF infection.A retrospective study compared the occurrence of CSF infection related to use of either standard silastic catheters or hydrogel-coated ventricular catheters (Bioglide, Medtronic). The enrolment was available to neurosurgery patients undergoing shunt surgery from October 2012 to 2015 in two centers. The follow-up period was more than months.A total of 78 patients were included in the study. In 33 patients 35-cm hydrogel-coated ventricular peritoneum shunts (VPS) were used, and in remaining 45 patients 35-cm standard silastic VPS catheters were used. Infection occurred in 14 (17.9%) patients, including definite VPS-related CSF infection in 6 patients (7.7%) and probable infection in remaining 8 patients (10.3%). There was a significant difference found in patients with total infection between the two groups [RR (95% CI); 0.200 (0.050-0.803), P = 0.014]. Analysis of Kaplan-Meier curve estimates indicated significant statistical difference between the two catheter types in duration (log rank = 4.204, P < 0.05). Significant statistical differences were also found in the subgroups including previous CSF infection within 1 month (log rank = 4.391, P = 0.04), conversion of external ventricular drains to shunt (Log Rank = 4.520, P = 0.03), and hospital stay >1 month (log rank = 5.252, P = 0.02). There was no difference found between the two groups of the patients with other infections within 1 month. The follow-up period was of 36 months.The hydrogel-coated catheter is a safe and related to lower infection rates for high-risk patients who underwent shunt surgery.
authors.affiliation: Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Department of Neurosurgery, Anhui Provincial Hospital, Hefei, Anhui, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Xu
authors.forename: Yimin
authors.initials: Y
authors.lastname: Huang
authors.forename: Wei
authors.initials: W
authors.lastname: Jiao
authors.forename: Wei
authors.initials: W
authors.lastname: Sun
authors.forename: Ran
authors.initials: R
authors.lastname: Li
authors.forename: Jiaqing
authors.initials: J
authors.lastname: Li
authors.forename: Ting
authors.initials: T
authors.lastname: Lei
mesh_terms: D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000517:prevention & control*; D020099:Coated Materials, Biocompatible; D003428:Cross Infection / Q000517:prevention & control*; D004129:Dimethylpolysiloxanes; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk; D017287:Ventriculoperitoneal Shunt / Q000295:instrumentation*
chemical_list: D020099:Coated Materials, Biocompatible; D004129:Dimethylpolysiloxanes; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; C013830:baysilon