Only antibiotic-impregnated suture , a no-shave policy , and double gloving with glove change prior to shunt h and ling , were associated with a significant reduction in shunt infection .
In a hospital with high methicillin-resistant staphylococcus aureus ( MRSA ) prevalence , a r and omized controlled trial found that perioperative vancomycin rather than cefazolin significantly reduced shunt infection rates .
Conclusion Despite wide variation in compliance rates , the implementation of comprehensive surgical protocol s reduced shunt infection in all published studies .
Antibiotic-impregnated suture , a no-shave policy , double gloving with glove change prior to device manipulation , and 5 % chlorhexidine hair wash were associated with significant reductions in shunt infection
Purpose Cerebrospinal fluid shunt infection is associated with patient morbidity and high cost .
We conducted a systematic review of the current evidence of comprehensive surgical protocol s or individual interventions design ed to reduce shunt infection incidence .
Infection rates following initial cerebrospinal fluid shunt placement across pediatric hospitals in the United States. Clinical article.
OBJECT Reported rates of CSF shunt infection vary widely across studies . The study objective was to determine the CSF shunt infection rates after initial shunt placement at multiple US pediatric hospitals . The authors hypothesized that infection rates between hospitals would vary widely even after adjustment for patient , hospital , and surgeon factors . METHODS This retrospective cohort study included children 0 - 18 years of age with uncomplicated initial CSF shunt placement performed between January 1 , 2001 , and December 31 , 2005 , and recorded in the Pediatric Health Information System ( PHIS ) longitudinal administrative data base from 41 children 's hospitals . For each child with 24 months of follow-up , subsequent CSF shunt infections and procedures were determined . RESULTS The PHIS data base included 7071 children with uncomplicated initial CSF shunt placement during this time period . During the 24 months of follow-up , these patients had a total of 825 shunt infections and 4434 subsequent shunt procedures . Overall unadjusted 24-month CSF shunt infection rates were 11.7 % per patient and 7.2 % per procedure . Unadjusted 24-month cumulative incidence rates for each hospital ranged from 4.1 to 20.5 % per patient and 2.5 - 12.3 % per procedure . Factors significantly associated with infection ( p < 0.05 ) included young age , female sex , African-American race , public insurance , etiology of intraventricular hemorrhage , respiratory complex chronic condition , subsequent revision procedures , hospital volume , and surgeon case volume . Malignant lesions and trauma as etiologies were protective . Infection rates for each hospital adjusted for these factors decreased to 8.8 - 12.8 % per patient and 1.4 - 5.3 % per procedure . CONCLUSIONS Infections developed in > 11 % of children who underwent uncomplicated initial CSF shunt placements within 24 months . Patient , hospital , and surgeon factors contributed somewhat to the wide variation in CSF shunt infection rates across hospitals . Additional factors may contribute to variation in CSF shunt infection rates between centers , but further study is needed . Benchmarking and future prospect i ve multicenter studies of CSF shunt infection will need to incorporate these and other patient , hospital , and surgeon factors
Only antibiotic-impregnated suture , a no-shave policy , and double gloving with glove change prior to shunt h and ling , were associated with a significant reduction in shunt infection .
In a hospital with high methicillin-resistant staphylococcus aureus ( MRSA ) prevalence , a r and omized controlled trial found that perioperative vancomycin rather than cefazolin significantly reduced shunt infection rates .
Conclusion Despite wide variation in compliance rates , the implementation of comprehensive surgical protocol s reduced shunt infection in all published studies .
Antibiotic-impregnated suture , a no-shave policy , double gloving with glove change prior to device manipulation , and 5 % chlorhexidine hair wash were associated with significant reductions in shunt infection
Purpose Cerebrospinal fluid shunt infection is associated with patient morbidity and high cost .
We conducted a systematic review of the current evidence of comprehensive surgical protocol s or individual interventions design ed to reduce shunt infection incidence .