Microbial infection as a complication of shunt surgery in a sample of Iraqi patients suffering from hydrocephalus

Abstract

Objectives. In this study, we aimed at assessing shunt infections in a sample of Iraqi patients who have been surgically treated with ventriculoperitoneal shunt. Materials and methods. A total of 208 patients were enrolled in this study. All of the patients have been submitted to diversion technique, namely ventriculoperitoneal shunt, due to hydrocephalus, with subsequent shunt infection. This work is conducted in specialized hospital for neurosurgery in Baghdad during the period extended from June 2018 to September 2022. Ten milliliters of cerebrospinal fluid (CSF) obtained during surgical removal of the shunt were, thereafter, investigated for bacterial infections as expected complications. Outcomes. Fifty six CSF samples (26.92%) out to f the 208 examined ones showed positive bacterial culture. Among the studied samples, the most affected age group was 1-5 years. The predominant bacteria were Staphylococcus aureus (37.5%), followed by Klebsiella spp. (32.1%). All Staphylococcus aureus infections were sensitive to Vancomycin, 42% to oxacillin, 28.5% to Fusidic acid and 9.5% to Cefotaxime, while 88.8% of Klebsiella showed sensitivity to Ciprofloxacin and 72% showed sensitivity to Meropenem. Conclusion. Ventriculoperitoneal shunt malfunction may result from different complications, and the bacterial infection represents an important one. Staphylococcus spp. is more commonly seen as causative agent of these infections, with gram negative rods come next.

Keywords

• ventriculoperitoneal shunt
• complications
• bacterial infection
• iraqi patients