The Contemporary Microbiology and Concomitant failure factors of ventriculoperitoneal shunts

Alqroom Rami; Al Drous Rafeed; Haddad Sizeph; Abu–nowar Hussam; Khasawneh Nidal

Volume : VI, Issue : VIII, August - 2017

The Contemporary Microbiology and Concomitant failure factors of ventriculoperitoneal shunts

Alqroom Rami, Al Drous Rafeed, Haddad Sizeph, Abu Nowar Hussam, Khasawneh Nidal

Abstract :

Background: ventriculo–peritoneal (VP) shunt insertion is the primary option in the treatment of Hydrocephalus. Though it is a well–established procedure, numerous factors have contributed to its failure. Ventriculo–peritoneal (VP) catheter occlusion remains a significant source of shunt morbidity in the pediatric population.

Impetus: This study carried out to analyze the VP shunt concomitant factors resulting in its failure. We seek to describe the current microbiology of shunt infection and coexisting factors leading to hardware failure.

Material and Methods: A retrospective review conducted in all patients presented at our clinic with shunt failure between January 2014 and December 2016. Forty one patients presented with signs and symptoms of hardware failure and infection. The study population was evaluated clinically and radiographically.

Results: Overall shunt failure was seen in 41–cases patients, constituting 15.58% of a total of 263 patients with hydrocephalus were treated. There were 24 males (58.53 %) and 17 females (41.46 %) with male to female ratio of 1.4:1. Age of patient ranged between 0 and 40 years with a median age of 11 years (�standard deviation of 4.2 � 2 years). The most common age group in this study was 1–14 years 36 (87.80%). Single and multiple shunt revisions were required in eight and five patients, respectively.

Conclusions: Ventriculo–peritoneal catheter insertion, though it is a well–established procedure, nevertheless there are still various and significant complications attendant with shunt diversion surgeries failure. Shunt infection remains a vexing problem. Staphylococcus aureus continues to be an important cause of shunt infections. The presence of concomitant factors are associated with higher failure rates.