Subcutaneous ventricular catheter reservoir and ventriculoperitoneal drain-related infections in preterm infants and young children

Objective In the period January 1990 to September 1997, 70 patients, aged u nder 6 years were treated for hydrocephalus with a subcutaneous ventricular catheter reservoir and/or a ventriculoperitoneal drain at the University H ospital of Maastricht. Methods By means of a retrospective chart analysis, the number of shunt inf ections and related risk factors were analyzed. Results Twenty-one patients (30%) developed one or more infections, with an infection rate of 15.2% per surgical event. For an implanted reservoir or drain, the infection rates were 15.9 and 16.4%, respectively. The study gro up consisted of 39 (55.7%) preterm infants (<37 weeks) and 31 (44.3%) full- term infants (greater than or equal to 37 weeks), with infection rates of 3 3.3 and 25.8%, respectively. At the first surgical intervention 28 patients (40%) had a postmenstrual age less than 37 weeks, with an infection rate o f 46.4%. At the lime of surgery, 69.7% of the patients were aged less than 6 months, with an infection rate of 19.6%. The most frequent causative micr oorganism of the shunt infections was staphylococcus epidermidis (42.1%). Conclusions Prematurity is an important risk factor for ventricular cathete r reservoir and ventriculoperitoneal drain-related infections, especially f or patients with a postmenstrual age of less than 37 weeks at their initial shunt placement and extreme low birth weight infants have a high risk for infection. In our opinion the use of adequate antibiotic prophylaxis and op timal infection control measures are necessary to keep the rate of infectio n as low as possible.