Infections following ventriculoperitoneal shunts in children and teenages

The management of hydrocephalus by means of aventriculoperitoneal shunt (VPS) has, as a major threat,s u rgical infections. Factors, such as cause of hydro-cephalus, age below six months, shunt primary insert i o n ,trainaing curve of surgeons, conditions of antisepsisand length of the pro c e d u re contribute to the occurre n c eof infectious complications. The study aimed at determining the incidence, cause,site of ocurrence and clinical and laboratory manifesta-tions of infections in the children and teenagens whounderwent VPS in Hospital Gov. Joao Alves, Aracaju-SE. Fifteen patients were studied prospectively fro mJanuary 2003 to October 2004. Hospital records wereanalised and data were obtained during hospital stayand after discharge. The results were analised throughYates Chi-square, Fisher’s exact test, relative risk and oddsratio. A confidence interval of 95% was used. All patientsunderwent VPS because of hipertensive hydrocephalusand subsequent infection rate per pro c e d u re was 27.6%.Infection rates according to surgical risk index were25.7% for risk 0 and 30.4% for risk 1/2 (NNISS-CDC).S u rgical site infection (deep and superficial) was themajor complication (87.5%) with early appearance (mean27.6 days). Fever was the most frequent sign in 13 of 16cases. Infection related mortaliy rate was 10% (5/50).However, there was no statistical significance for causeof hydrocephalus (p=0.858), type of pro c e d u re (p=0.330),age at diagnosis (p=0.926), pre-operative length of stay(p=0.172), duration of pro c e d u re (p=0.534, RR=1.09,IC95% [0.6-2.0]), antibiotic prophylaxis (p=0.567), pre-vious use of CNS catheter (p=0.361) and risk index (0, 1,