Nosocomial meningitis in children after ventriculoperitoneal shunt insertion

This study reviews 33 cases of ventriculoperitoneal shunt (VPS) meningitis among 415 children after 540 shunt insertions within 8 y, in 9 paediatric i ntensive care units from 5 centres in Slovakia. The incidence of VPS mening itis was 6.3% per insertion. The most common organisms isolated from cerebr ospinal fluid (CSF) and shunt were coagulase-negative staphylococci (52.8%) , followed by Staphylococcus aureus (13.1%) and Pseudomonas aeruginosa (7.5 %). Seven of 15 assessed risk factors were significantly associated with VP S meningitis, compared with non-VPS meningitis: prior meningitis with hydro cephalus (15.1 vs 1.5%, p < 0.015), perinatal pathology (51.1 vs 1.5%, p < 0.001), very low birthweight (66.6 vs 16.2%, p < 0.001), polymicrobial noso comial meningitis (30.3 vs 5.9%, p < 0.002), S. aureus (21.2 vs 7.3%, p < 0 .05), coagulase-negative staphylococci (84.8 vs 30.9%, p < 0.001) and P. ae ruginosa and Acinetobacter calcoaceticus (30.3 vs 4.5%, p < 0.001) in aetio logy.