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  • Prevention of Ventricular Shunt Infection in Adults

    Final Number:

    Anthony Michael Burrows MD; Meghan Murphy MD; Fredric B. Meyer MD

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: Shunt infection is frequent complication of ventricular shunting for hydrocephalus. Several techniques for shunt infection control have been reported including reservoir injection of a vancomycin/gentamycin solution and the use of antibiotic impregnated catheters.

    Methods: A database of all ventriuclo-peritoneal shunt procedures performed at the Mayo Clinic Rochester from January 2000-August 2013 was retrospectively reviewed. As the intention of the study was infection rates in adult patients, only patients 18 years or older at the time of shunt implantation were included. Infections were identified by a separate prospective database. Use of vancomycin-gentamycin solution and antibiotic catheters were identified by billing records. The primary outcome measure was shunt infection. Groups were compared by the use of antibiotic catheters and vancomycin/gentamycin solution vs use of one alone or none.

    Results: A total of 516 records met inclusion criteria. Patients had a mean age of 61±19 years old (range 18-93). Twenty two infections (6.6 %) were seen among the 336 patients who did not receive the antibiotic solution or antibiotic catheters while 6 infections (3.3%) were seen among the 180 patients who received both. The relative risk 0.51 for shunt infection with antibiotic solution and antibiotic impregnated catheters did not reach statistical significance on univariate analysis, (95% CI 0.21-1.2, p=0.13).

    Conclusions: Shunt reservoir irrigation with vancomycin/gentamycin solution and the use of antibiotic impregnated catheters may help reduce shunt infection rates, but larger and better powered studies are needed.

    Patient Care: By helping to prevent VP shunt infections

    Learning Objectives: By the Conclusion of the sessionm participanst should be able to #1 Describe measures that may prevent shunt infection #2 Describe a complication of shunt placement #3 Describe the improtance of preventing shunt infections


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