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Difficult-to-treat CSF shunt infections likely to flare up again
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Factors associated with an initial difficult-to-treat cerebrospinal fluid shunt infection are also associated with reinfection, researchers from the University of Washington suggest.
The retrospective cohort study included 118 children who developed a cerebrospinal fluid (CSF) shunt infection after their initial CSF shunt placement. The researchers evaluated factors associated with CSF shunt reinfection.
Among the children who developed infection, 31 developed a reinfection during a median follow-up of 2,096 days. Patients who received a ventriculoatrial or complex shunt at the initial shunt placement and patients who had a complication after the first CSF shunt infection had a higher risk for reinfection. In addition, intermittent negative CSF cultures were associated with reinfection.
“Surprisingly few patient, diagnostic, or treatment factors were associated with reinfection,” said Tamara D. Simon, MD, MSPH, assistant professor of pediatrics, department of pediatrics, division of hospital medicine, University of Washington and Seattle Children’s Hospital Center for Clinical and Translational Research, Seattle Children's Research Institute.
Tamara D. Simon
The findings also support a growing body of evidence that “demonstrates clinical equipoise in the treatment of CSF shunt infection because the superiority of particular medical or surgical approaches to the treatment of CSF shunt infection has not been established,” Simon and colleagues wrote.
Tamara D. Simon, MD, MSPH, can be reached at the University of Washington Department of Pediatrics, Division of Hospital Medicine, Seattle Children’s Research Institute Bldg 1, M/S C9S-9, 1900 Ninth Ave, Seattle, WA 98101; email: tamara.simon@seattlechildrens.org.
Disclosure: The researchers report no relevant financial disclosures.
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