Clinical and microbiological characteristics of infections associated with ventricular shunt systems and third ventriculostomy at a reference center (2018-2022)

Abstract

Abstract

Background: Ventricular cerebrospinal fluid shunt systems (CSF shunts) can lead to infections that increase morbidity and mortality. Aim: To describe the clinical, epidemiological, microbiological, and developmental characteristics of patients with shunt-associated ventriculitis hospitalized at Centro Hospitalario Pereira Rossell in Uruguay, between 2018 and 2022. Methodos: A cross-sectional study was conducted by reviewing medical records. Patients under 15 years of age with a diagnosis of ventriculitis were included. Epidemiological variables, risk factors, clinical, developmental, paraclinical, and microbiological data were analyzed. Results: During the study period, 21 episodes of ventriculitis occurred in 17 children, all associated with ventriculoperitoneal shunts. Most cases occurred within the first month post-surgery, with fever and symptoms of intracranial hypertension as common signs. Main risk factors included age under 6 months, with the primary causes of hydrocephalus being malformative and hemorrhagic. The most common microorganisms were Staphylococcus epidermidis and Staphylococcus aureus, with a high resistance to methicillin. Initial empirical treatment combined vancomycin and ceftriaxone or cefotaxime. Conclusions: Most cases of shunt-associated ventriculitis occurred in children with risk factors, predominantly within the first month after surgery and were generally monomicrobial. Empirical antibiotic therapy aligns well with microbiological findings.