MANTERO E, CECCARELLI R, DONDERO M, BUCCI B, RUSSO G, CAMA A, PIATELLI G, RATTO S, BASSETTI D; Interscience Conference on Antimicrobial Agents and Chemotherapy.

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 610 (abstract no. 764).

Clin. Infectious Diseases - Univ. of Genoa, Genoa, ITALY

BACKGROUND: Up to date, there is no data about the incidence and factors affecting CSF-shunt infection (SI) rate in children with hydrocephalus (HY) in Italy. Therefore we performed a retrospective study in patients (pts) underwent CSF-shunt surgery for HY.METHODS: We reviewed 2047 surgical procedures for CSF shunt in 1804 children with HY from 1980 to1998. From 1986, we designed clinical practice guidelines (CPGs) for the control of SI, regarding neurosurgical, microbiological, pharmacokinetic and therapeutic aspects. We valued as risk factors(RF): age at the time of shunt placement(ASP), underlying disease, neurosurgical procedure, duration of external shunt.RESULTS: The SI incidence rate for patient and procedure was 1.72% and 1.51%. The SI incidence rate for procedure was 4.03% in 1980-1985 (1st) and 0.97% in 1986-1998 (2nd) (p<0,0001). The intraventricular therapy time (ITT)(mean+/-SD)was 21+/-12 vs. 8+/-5 days (1st vs. 2nd period p=0.0325): similarly the recoveries were 11 out of 16 and 14 out of 15 infections (p=0.1719). Four pts. died in 1st period and none in 2nd period: multilocular HY was observed in 1 out of 16 and 1 out of 15 pts., respectively. ASP (months) was 62.5 (95% C.I. 57.5-67.5) for the uninfected and 37.5 (95% C.I. 15-60) for the infected pts. (p=0.0493); on the Spina Bifida group (SB), ASP was 55 (95% C.I. 46-67) and 12 (95% C.I. 1-25), respectively (p=0.0032). For the other RF, the p-value was always >0.05.CONCLUSIONS: ASP is the main RF of infection, especially on SB. The interaction of other RF and infection seems to have no influence. In the 2nd period, the reduction of SI incidence and the very low mortality and complications rate, in spite of a shorter ITT, are probably related to the application of CPGs.

Publication Types:

• Meeting Abstracts

Keywords:

• Child
• Communicable Diseases
• Humans
• Hydrocephalus
• Infection
• Italy
• Prosthesis-Related Infections
• Retrospective Studies
• Risk Factors
• Spinal Dysraphism
• Surgical Wound Infection

Other ID:

• GWAIDS0008662

UI: 102246159

From Meeting Abstracts