Evaluation of Pathogens in Shunt Infections Developed in Newborns Underwent Ventriculoperitoneal Shunt for Hydrocephaly

Abstract

Objectives: The ventriculoperitoneal (VP) shunt is the most commonly used treatment modality in hydrocephaly. However, VP shunt infection is a common, severe complication with high mortality and morbidity rate. The aim of the study was to evaluate clinical characteristics, shunt infections and pathogen agents in newborns underwent VP shunt procedure for hydrocephaly. Materials and Methods: This retrospective study was conducted in Neonatal Intensive Care Unit of Harran University, Faculty of Medicine between January, 2016 and June, 2021. The study included all newborns admitted with hydrocephaly and underwent VP shunt procedure. Results: The study included 52 cases with hydrocephaly. Of the cases shunt infection plus meningitis was develop in 28 (53.8%) while no shunt infection plus meningitis was developed in 24 (46.2%). Of the cases developed shunt infection plus meningitis, 8 were boys (28.6%) and 20 were girls (71.4%). Of the cases with growth in culture tests, Gram-positive bacteria were detected in 5 (18.0%) whereas Gram-negative enteric and nonfermenter bacteria in 22 (78.4%) and Candida parapsilosis in one (3.6%). Conclusion: In our study, we found that the incidence of Gram-negative bacterial infection was high. We believe that treatment with Gramnegative coverage will be appropriate until culture test results available when VP shunt infection is suspected.

Keywords

• Hydrocephaly
• Shunt Infection
• Newborn

Hidrosefali Tanısı ile Ventriküloperitoneal Şant Takılan Yenidoğan Hastalarda Gelişen Şant Enfeksiyon Etkenlerinin Araştırılması

Abstract

Amaç: Ventriküloperitoneal (VP) şant, hidrosefali için en yaygın tedavi yöntemidir. Bununla birlikte, VP şant enfeksiyonu, yüksek mortalite ve morbidite oranları ile yaygın ve ciddi bir komplikasyondur. Bu çalışmanın amacı, hidrosefali nedeni ile takip edilen ve VP şant takılan neonatal hidrosefali olgularının klinik özellikleri, gelişen şant enfeksiyonları ve enfeksiyon etkenleri açısından değerlendirmektir. Gereç ve Yöntem: Bu çalışma, retrospektif olarak, 2016 Ocak-2021 Haziran tarihleri arasında, 3. basamak bir hastane olan Harran Üniversitesi Tıp Fakültesi Yenidoğan Yoğun Bakım Ünitesi’nde gerçekleştirildi. Çalışmaya hidrosefali tanısı ile yatan ve VP şant takılan tüm yenidoğanlar dahil edildi. Bulgular: Çalışmaya hidrosefali tanılı 52 olgu dahil edildi. Olguların 28‘inde (%53,8) şant enfeksiyonu+menenjit gelişirken, olguların 24’ünde (%46,2) şant enfeksiyonu+menenjit gelişmedi. Şant enfeksiyonu+menenjit gelişen olguların 8 erkek (%28,6), 20 kız (%71,4) bebek olduğu görüldü. Kültürde üreme tespit edilen olguların 5’inde (%18) Gram-pozitif bakteriler ve 22’sinde (%78,4) Gram-negatif enterik ve non-fermenter bakteriler, 1’inde (%3,6) Candida parapsilozis saptandı. Sonuç: Çalışmamızda Gram-negatif bakteriyel enfeksiyon insidansının yüksek olduğunu tespit ettik. VP şant enfeksiyonu düşünüldüğü durumlarda kültür sonucu çıkana kadar Gram-negatif etkenlere yönelik tedavi başlanmasının uygun olacağını düşünmekteyiz.

Keywords

• Hidrosefali
• Şant Enfeksiyonu
• Yenidoğan

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