THE SIGNIFICANCE OF BACTERIOLOGICALLY POSITIVE VENTRICULOPERITONEAL SHUNT COMPONENTS IN THE ABSENCE OF OTHER SIGNS OF SHUNT INFECTION

The purpose of this study was to determine the significance of ''asymp tomatic bacteriological shunt contamination'' (ABSC), defined as a pos itive bacteriological culture found on a ventricular shunt component i n the absence of bacteria in the cerebrospinal fluid (CSF) culture and /or clinical evidence of infection. Of 174 ventriculoperitoneal shunt revisions, 19 cases of ABSC were identified and reviewed retrospective ly. Ln all but one case, no antibiotic medications were instituted bec ause of the positive bacteriological culture. The most common infectin g organisms were coagulase-negative staphylococci (seven) and propioni bacteria (eight). A comparison of the 19 study cases with the authors' overall shunt experience, as documented in the British Columbia's Chi ldren's Hospital shunt database for the time period of the study, lead the authors to suggest that ABSC was not of significance in causing t he shunt failure at which contamination was identified and, more impor tantly, did not increase the risk of future shunt malfunction. The res ults of this study indicate that in the absence of clinical evidence o f shunt infection or a positive bacteriological culture from CSF, bact eria in a shunt component removed at revision in a child almost always represents a contaminant that may be ignored. Therefore, the authors advise that routine culture of shunt components removed at revision of a shunt is not indicated.