Infections of cerebrospinal fluid (CSF) shunt in children are becoming more common in clinical practice. For a study, researchers sought to analyse clinical, laboratory, and microbiologic parameters associated with infections in children. They also sought to evaluate results by type of catheter (medicated or not), type of infection (first or relapses), type of hydrocephalus (acquired or congenital), presence or absence of bacteriemia, and define antibiotic susceptibilities and their evolution during the study period. A total of 87 children with shunt infection and 61 children with mechanical shunt failure were included in the study. The infected group had more fever, vomit, leukocytosis, and elevated C-reactive protein (P<0.001), whereas the noninfected group had more neurologic symptoms (10.3% vs 27.87%; P=0.006). Both groups reported similar local signs of inflammation and abdominal distension. In comparison to children with non-medicated shunts (380/mm3; P<0.0001), children with medicated shunts had a lower cell count in the CSF (12/mm3). Gram-negative bacteria were found in higher numbers in non-medicated catheters (90.91% vs 50% of cultures; P=0.04). Gram-negative bacteria were found in 50.67% of CSF cultures, Gram-positive bacteria in 53.33%, and fungi in 5.33% of the cultures. Positive blood culture was also found in 16 children (18.4%). Relapsed infections were linked to enterococci isolation (37.50% vs 15.25%; P=0.05). The outcomes showed that diagnosing and treating children with shunt infections was difficult. Prospective studies focusing on the patient, medical, microbiologic, and surgical risk factors for the first infection were desperately needed.

 

Source:journals.lww.com/pidj/Fulltext/2022/04000/Cerebrospinal_Fluid_Shunt_Infections_in_Children_.19.aspx

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