Etiologic and Prognostic Assessment of Children with Ventriculoperitoneal Shunt Infections

Objective: In this study, the children with ventriculoperitoneal shunt infections hospitalized between December 2001- August 2008 in a research hospital were evaluated retrospectively in terms of some aspects. Material and Methods: Diagnosis of shunt infections was based on history, physical examination and analysis of ventricle cerebrospinal fluid (CSF). The differential diagnosis between meningitis and ventriculitis was based on CSF and magnetic resonance imaging findings in addition to clinical findings. The patients were evaluated retrospectively in terms of time of infection, the causative agents, duration of hospitalization and its relationship with various factors and factors affecting the prognosis.Results: The study comprised 40 children, 31 of whom (77.5%) were diagnosed as meningitis and 9 (22.5%) as ventriculitis. Thirty five patients had positive CSF cultures, in 12 of whom (30%) S.epidermidis and S. aureus were isolated. In 17 cases, more than one microorganism were isolated, among which coagulase negative staphylococci constituted the majority. For the treatment of infection, the shunts were removed in 16 patients and external ventricular drainage procedures were made, in 11 patients intrathecal antibiotics were administered. Over half of the patients (52.5%) stayed in hospital longer than 30 days and five patients (12.5%) died during treatment. Conclusion: Infections are important complications in children with ventriculoperitoneal shunts and they lead to long-term hospitalization and a high mortality rate.