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Article: A multicenter multinational registry for assessing ventriculoperitoneal shunt infections for hydrocephalus

TitleA multicenter multinational registry for assessing ventriculoperitoneal shunt infections for hydrocephalus
Authors
Issue Date2010
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.neurosurgery-online.com
Citation
Neurosurgery, 2010, v. 67 n. 5, p. 1303-1310 How to Cite?
AbstractBackground: Reported infection rates after ventriculoperitoneal shunt surgery vary from 1 to 25%. Antibiotic-impregnated (AI) catheters may reduce shunt infection rates, but this is uncertain. Objective: To establish a prospective shunt registry to evaluate short-term (3-month) infection rates associated with ventriculoperitoneal shunts and standard or AI catheters during surgical treatment of hydrocephalus. Methods: A prospective, multicenter, noncontrolled, open-label registry investigated patients with de novo catheter implantation or catheter replacement of an existing ventriculoperitoneal shunt. The primary outcome was shunt infection. Results: A total of 440 patients were entered into the registry at 10 sites: 3 in North America, 2 in Singapore, 4 in China and 1 in India. Seven patients were excluded. Of the 433 remaining patients, 314 had new shunts and 119 were revisions. Shunt infections occurred in 14 of 433 patients (3.2%) overall and in 2 of 37 infants (5.2%) younger than 1 year. AI catheters were used in 46 of 433 patients at 7 centers. The shunt infection rate was 0 of 46 for shunts with AI catheters and 14 of 387 (3.6%) without AI catheters. Infection rates were similar with AI catheters, adjusting for age and catheter type. Conclusion: The overall shunt infection rate was lower than in previous multicentered studies. The low infection rate and low rate of AI catheter use precludes any meaningful statement regarding the value of AI catheters in reducing the infection rate. Consideration should be given to performing a well designed, adequately powered, prospective randomized controlled trial to determine whether AI catheters reduce shunt infection rates. © 2010 by the Congress of Neurological Surgeons.
Persistent Identifierhttp://hdl.handle.net/10722/173010
ISSN
2015 Impact Factor: 3.78
2015 SCImago Journal Rankings: 1.414
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorSteinbok, Pen_US
dc.contributor.authorMilner, Ren_US
dc.contributor.authorAgrawal, Den_US
dc.contributor.authorFarace, Een_US
dc.contributor.authorLeung, GKKen_US
dc.contributor.authorNg, Ien_US
dc.contributor.authorTomita, Ten_US
dc.contributor.authorWang, Een_US
dc.contributor.authorWang, Nen_US
dc.contributor.authorChu Wong, GKen_US
dc.contributor.authorZhou, LFen_US
dc.date.accessioned2012-10-30T06:26:27Z-
dc.date.available2012-10-30T06:26:27Z-
dc.date.issued2010en_US
dc.identifier.citationNeurosurgery, 2010, v. 67 n. 5, p. 1303-1310en_US
dc.identifier.issn0148-396Xen_US
dc.identifier.urihttp://hdl.handle.net/10722/173010-
dc.description.abstractBackground: Reported infection rates after ventriculoperitoneal shunt surgery vary from 1 to 25%. Antibiotic-impregnated (AI) catheters may reduce shunt infection rates, but this is uncertain. Objective: To establish a prospective shunt registry to evaluate short-term (3-month) infection rates associated with ventriculoperitoneal shunts and standard or AI catheters during surgical treatment of hydrocephalus. Methods: A prospective, multicenter, noncontrolled, open-label registry investigated patients with de novo catheter implantation or catheter replacement of an existing ventriculoperitoneal shunt. The primary outcome was shunt infection. Results: A total of 440 patients were entered into the registry at 10 sites: 3 in North America, 2 in Singapore, 4 in China and 1 in India. Seven patients were excluded. Of the 433 remaining patients, 314 had new shunts and 119 were revisions. Shunt infections occurred in 14 of 433 patients (3.2%) overall and in 2 of 37 infants (5.2%) younger than 1 year. AI catheters were used in 46 of 433 patients at 7 centers. The shunt infection rate was 0 of 46 for shunts with AI catheters and 14 of 387 (3.6%) without AI catheters. Infection rates were similar with AI catheters, adjusting for age and catheter type. Conclusion: The overall shunt infection rate was lower than in previous multicentered studies. The low infection rate and low rate of AI catheter use precludes any meaningful statement regarding the value of AI catheters in reducing the infection rate. Consideration should be given to performing a well designed, adequately powered, prospective randomized controlled trial to determine whether AI catheters reduce shunt infection rates. © 2010 by the Congress of Neurological Surgeons.en_US
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.neurosurgery-online.comen_US
dc.relation.ispartofNeurosurgeryen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshHydrocephalus - Epidemiology - Surgeryen_US
dc.subject.meshInfanten_US
dc.subject.meshInfant, Newbornen_US
dc.subject.meshInternational Cooperationen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPrevalenceen_US
dc.subject.meshProsthesis-Related Infections - Epidemiologyen_US
dc.subject.meshRegistries - Statistics & Numerical Dataen_US
dc.subject.meshRisk Assessmenten_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshVentriculoperitoneal Shunt - Utilizationen_US
dc.subject.meshYoung Adulten_US
dc.titleA multicenter multinational registry for assessing ventriculoperitoneal shunt infections for hydrocephalusen_US
dc.typeArticleen_US
dc.identifier.emailLeung, GKK: gilberto@hkucc.hku.hken_US
dc.identifier.authorityLeung, GKK=rp00522en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1227/NEU.0b013e3181f07e76en_US
dc.identifier.pmid20871445-
dc.identifier.scopuseid_2-s2.0-77958455852en_US
dc.identifier.hkuros183209-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77958455852&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume67en_US
dc.identifier.issue5en_US
dc.identifier.spage1303en_US
dc.identifier.epage1310en_US
dc.identifier.isiWOS:000283479500031-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridSteinbok, P=7005579613en_US
dc.identifier.scopusauthoridMilner, R=7202498076en_US
dc.identifier.scopusauthoridAgrawal, D=8958153000en_US
dc.identifier.scopusauthoridFarace, E=6603180784en_US
dc.identifier.scopusauthoridLeung, GKK=35965118200en_US
dc.identifier.scopusauthoridNg, I=7102753732en_US
dc.identifier.scopusauthoridTomita, T=35479560300en_US
dc.identifier.scopusauthoridWang, E=13407534600en_US
dc.identifier.scopusauthoridWang, N=41862847000en_US
dc.identifier.scopusauthoridChu Wong, GK=35421924500en_US
dc.identifier.scopusauthoridZhou, LF=8520969000en_US

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