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Original Paper
Pediatr Neurosurg 2013;49:75–80
DOI: 10.1159/000357384
Determinants and Outcomes of
Ventriculoperitoneal Shunt Infections
in Enugu, Nigeria
E.O. Uche E. Onyia U.C. Mezue E. Okorie I.I. Ozor M.C. Chikani
Neurological Surgery Unit, Department of Surgery, College of Medicine, University of Nigeria Teaching Hospital,
Enugu, Nigeria
the most common pathogen. The mortality rate in our series
was 21.4% in patients with SI compared to 2.7% in those
without SI. Conclusion: Coagulase-negative Staphylococcus
is currently the most common cause of SI and underweight
children appear have a higher risk. © 2014 S. Karger AG, Basel
Introduction
Although ventriculoperitoneal (VP) shunt placement
remains the mainstay of surgical treatment for hydro-
cephalus, infection has become a formidable cause of
morbidity and mortality in hydrocephalic children treat-
ed with a VP shunt [1]. Although the source of infection
is quite often the patient’s skin, other foci may also con-
tribute significantly. Early detection coupled with
prompt institution of appropriate intervention has prov-
en to be the determinant of successful treatment out-
comes in the experience of many a neurosurgeon. This
study aims to evaluate the determinants of shunt infec-
tion (SI), the microbial and treatment patterns, and the
outcome of treatment in a reemerging neurological sur-
gery unit in Southeastern Nigeria.
Key Words
Ventriculoperitoneal shunt · Shunt infection · Risk factors ·
Outcome
Abstract
Background: To evaluate the determinants and outcomes of
shunt infection (SI). Methods: One hundred ninety-eight pe-
diatric hydrocephalic patients treated with a ventriculoperi-
toneal (VP) shunt between January 2008 and August 2012
were retrospectively studied. Patients with SI were com-
pared to those without SI in terms of the occurrence of risk
factors and outcomes. Data was analyzed using Statistical
Package for the Social Sciences software (version 15). Re-
sults: The age range was 2 weeks to 13 years, with a mean
age of 3.1 ± 0.19 years for the SI group versus 2.7 ± 0.2 years
for those without SI. One hundred and twelve patients were
female and 86 were male. SI was recorded in 17 (8.6%) pa-
tients. Postinfective hydrocephalus (n = 6) was the most
common cause of hydrocephalus in the SI group. Individuals
in the SI group, compared to those without infection, were
more likely to be underweight (χ
2
= 23.4, p < 0.01). The mean
interval between VP shunt placement and SI was 1.83 ± 1.25
months. Coagulase-negative Staphylococcus (29.4%) was
Received: May 31, 2013
Accepted after revision: October 10, 2013
Published online: January 9, 2014
Dr. Enoch Ogbonnaya Uche
Lecturer/Consultant Neurosurgeon
Department of Surgery, College of Medicine
University of Nigeria, Enugu Campus, Enugu (Nigeria)
E-Mail kechyenny @ yahoo.com
© 2014 S. Karger AG, Basel
1016–2291/14/0492–0075$39.50/0
www.karger.com/pne