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Operative Related Infection Rates for Ventriculoperitoneal Shunt Procedures in a Children's Hospital

Published online by Cambridge University Press:  02 January 2015

Janara J. Younger
Affiliation:
Departments of Pediatrics and Neurosurgery, University of Tennesseeand Le Bonheur Children's Medical Center, Memphis, Tennessee
James C.H. Simmons
Affiliation:
Departments of Pediatrics and Neurosurgery, University of Tennesseeand Le Bonheur Children's Medical Center, Memphis, Tennessee
Fred F. Barrett
Affiliation:
Departments of Pediatrics and Neurosurgery, University of Tennesseeand Le Bonheur Children's Medical Center, Memphis, Tennessee

Abstract

We determined the operative related cerebrospinal fluid (CSF) shunt infection rates for our institution over a 3-year period (1982 to 1984) using strictly defined numerator and denominator data. The minimum post-operative follow-up period was 12 months. The average surgical infection risk for a CSF shunt procedure at our institution during the study period was 13.3%. Annual infection rates were relatively constant (13.8%, 13.2% and 12.9%), however both quarterly (5.7% to 23.3%) and surgeon-specific (5.7% to 22.8%) rates varied widely. Infection rates calculated by using “traditional” numerator and denominator data were considerably lower (6.5% to 9.2%).

Operative related CSF shunt infection rates should be determined by utilizing strictly defined numerator and denominator values in order to allow valid comparisons of published rates.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1987

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References

1.Gardner, BP, Gordon, DS: Postoperative infection in shunts for hydrocephalus: Are prophylactic antibiotics necessary? Br Med J 1982: 284:19141915.Google Scholar
2.Venes, J: Control of shunt infection. Report of 150 consecutive cases. J Neurosurg 1976: 45:311315.Google Scholar
3.O'Brien, M, Parent, A, Davis, B: Management of ventricular shunt infections. Child's Brain 1979; 5:304309.Google ScholarPubMed
4.George, R, Leibrock, L, Epstein, M: Long-term analysis of cerebrospinal fluid shunt infections. A 25 year experience. J Neurosurg 1979; 51:804811.Google Scholar
5.Raimondi, AJ, Robinson, JS, Kuwamura, K: Complications of ventriculoperitoneal shunting and a critical comparison of the three-piece and one-piece systems. Child's Brain 1977; 3:321342.Google Scholar
6.Schoenbaum, SC, Gardner, P, Shillito, J: Infections of cerebrospinal fluid shunts: Epidemiology, clinical manifestation, and therapy. J Infect Dis 1975; 131:543552.Google Scholar
7.McCullough, DC, Kane, JG, Presper, JH, et al: Antibiotic prophylaxis in ventricular shunt surgery. I. Reduction of operative rates with methicillin. Child's Brain 1980; 7:182189.Google Scholar
8.McCullough, DC, Kane, JG, Harleman, G, et al: Antibiotic prophylaxis in ventricular shunt surgery. II. Antibiotic concentrations in cerebrospinal fluid. Child's Brain 1980; 7:190194.Google Scholar
9.Ajir, F, Levin, AB, Duff, TA: Effect of prophylactic methicillin on cerebrospinal fluid shunt infections in children. Neurosurg 1981; 9:68.Google Scholar
10.Haines, SJ, Taylor, F: Prophylactic methicillin for shunt operations: Effects on incidence of shunt malfunction and infection. Child's Brain 1982; 9:1022.Google Scholar
11.Odio, C, Mohs, E, Sklar, F, et al: Adverse reactions to vancomycin used as prophylaxis for CSF shunt surgery. Am J Dis Child 1984; 138:1719.Google Scholar
12.Wang, EE, Prober, CG, Hendrick, BE: Prophylactic sulfamethoxazole and trimethoprim in ventriculoperitoneal shunt surgery. A double-blind, randomized, placebo-controlled trial. JAMA 1984; 251:11741177.Google Scholar
13.Nelson, JD: Cerebrospinal fluid shunt infections. Pediatr Infect Dis 1984; 3(suppl):S30S32.Google Scholar
14.Yogev, R: Cerebrospinal fluid shunt infections: A personal view. Pediatr Infect Dis 1985; 4:113117.Google Scholar
15.Sells, CJ, Shurtleff, DB, Loeser, JD: Gram-negative cerebrospinal fluid shunt-associated infections. Pediatrics 1977; 59:614618.Google Scholar
16.Bayston, R, Lari, J: A study of the sources of infection in colonized shunts. Dev Med Child Neurol 1974; 16(suppl 32):1621.Google Scholar
17.Yogev, R, Davis, AT: Neurosurgical shunt infections. A review. Child's Brain 1980; 6:7481.Google ScholarPubMed