Evaluation of Ventriculoperitoneal Shunt Infections in Children

Objective: Ventriculoperitoneal shunt (VPS) infection is an important cause of morbidity and mortality in both adults and children with hydrocephalus. Inappropriately treated shunt infections may cause of mental retardation, neurological deficits and also death in patients. The aim of this study was to determine the demographic characteristics, the causes of hydrocephalus, microorganisms responsible for infection, antibiotic susceptibility of microorganisms and treatment modalities of the pediatric patients treated with VPS infection. Material and Methods: Medical records of the patients, who were treated with a diagnosis of VPS infection in the Farabi Hospital of Karadeniz Technical University Medical Faculty between 2012-2018, were reviewed retrospectively. Results: Ventriculoperitoneal shunt was implemented in 362 children. In the follow-up of 26 patients, 29 VPS infection episodes were developed. The most common causes of VPS infection were congenital malformation. Staphylococcus epidermidis (34.5%), Enterococcus faecium (13.8%), Escherichia coli (10.3%), Serratia liquefaciens (6.9%), Bacillus megaterium (6.9%), Staphylococcus aureus (3.4%), Klebsiella pneumoniae (3.4%), Candida albicans (3.4%) were yielded in the cerebrospinal fluid. Insertion of an extraventricular drain (EVD) was applied five patients, insertion of an extraventricular drain and removal of the infected shunt was applied 13 patients. Of the eight patients whose shunt had not been removed, VPS re-infection was developed in three patients. VPS re-inserted in 12 patients. Three patients died. Conclusion: The treatment of shunt infections is substantially difficult and consequently have high economic costs. Venticuloperitoneal shunt infections may be presented silent. Suspicion of VPS infection is very important for diagnosis. Simple measures to be applied meticulously during surgery can significantly reduce the infection rate.