Management of Recurrent Ventriculoperitoneal Shunt Infections in Adult Patients
<b>Objective:</b> The objective of this study was to evaluate the demographic, clinical, laboratory, and microbiological features of ventriculoperitoneal shunt (VPS) infections through a 13-year retrospective study. VPS bacterial agents and their antibiotic susceptibility were also inves...
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MDPI AG
2025-01-01
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| author | Neval Elgormus Yusuf Elgormus Bagnu Dundar Fatma Bozkurt Huseyin Dogu Hafize Uzun |
| author_facet | Neval Elgormus Yusuf Elgormus Bagnu Dundar Fatma Bozkurt Huseyin Dogu Hafize Uzun |
| author_sort | Neval Elgormus |
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| description | <b>Objective:</b> The objective of this study was to evaluate the demographic, clinical, laboratory, and microbiological features of ventriculoperitoneal shunt (VPS) infections through a 13-year retrospective study. VPS bacterial agents and their antibiotic susceptibility were also investigated through the occurrence of single VPS (SVPS) and recurrent VPS (RVPS) infections. <b>Methods:</b> This study included 110 patients with SVPS infections and 55 patients with RVPS infections. <b>Results:</b> In patients who developed multiple infections, Gram-negative organisms were found to be the most predominant (60%, 54/90). The resistance rates were 85.2% for third-generation cephalosporins (3GCs), 83.3% for piperacillin–tazobactam, and 10.4% for carbapenem. Of the patients in the SVPS infection group, 49% were treated with combinations with carbapenem; of the patients in the RVPS infection group, 84.4% were treated in the same way. Central nervous system (CNS) tuberculosis as the etiology of hydrocephalus; short duration of antibiotics used for treatment; high cerebrospinal fluid (CSF) protein and blood C-reactive protein (CRP) levels; and prolonged use of prophylactic antibiotics were found to be related to an increased rate of recurrent infection occurrence. A two-stage shunt change approach decreased the risk of recurrent infections. <b>Conclusions:</b> Based on the findings of our study, it is essential to closely monitor patients with independent risk factors for RVPS infection development, due to the high rates of resistant Gram-negative bacterial growth and the initiation of empirical antimicrobial treatment with glycopeptide plus carbapenem. Certain treatment options, such as 3GCs plus glycopeptide, should be revised based on clinical progress and microbiological culture results. |
| format | Article |
| id | doaj-art-ec06765a81d24d2e99d79fdf41bb369c |
| institution | Kabale University |
| issn | 2079-6382 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj-art-ec06765a81d24d2e99d79fdf41bb369c2025-01-24T13:18:53ZengMDPI AGAntibiotics2079-63822025-01-011417710.3390/antibiotics14010077Management of Recurrent Ventriculoperitoneal Shunt Infections in Adult PatientsNeval Elgormus0Yusuf Elgormus1Bagnu Dundar2Fatma Bozkurt3Huseyin Dogu4Hafize Uzun5Department of Microbiology, Faculty of Medicine, Istanbul Atlas University, 34303 Istanbul, TurkeyDepartment of Child Health and Diseases, Medicine Hospital, Istanbul Atlas University, 34408 Istanbul, TurkeyDepartment of Medical Biochemistry, Faculty of Medicine, Istanbul Atlas University, 34303 Istanbul, TurkeyDepartment of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Atlas University, 34303 Istanbul, TurkeyDepartment of Neurosurgery, Faculty of Medicine, Istanbul Atlas University, 34303 Istanbul, TurkeyDepartment of Medical Biochemistry, Faculty of Medicine, Istanbul Atlas University, 34303 Istanbul, Turkey<b>Objective:</b> The objective of this study was to evaluate the demographic, clinical, laboratory, and microbiological features of ventriculoperitoneal shunt (VPS) infections through a 13-year retrospective study. VPS bacterial agents and their antibiotic susceptibility were also investigated through the occurrence of single VPS (SVPS) and recurrent VPS (RVPS) infections. <b>Methods:</b> This study included 110 patients with SVPS infections and 55 patients with RVPS infections. <b>Results:</b> In patients who developed multiple infections, Gram-negative organisms were found to be the most predominant (60%, 54/90). The resistance rates were 85.2% for third-generation cephalosporins (3GCs), 83.3% for piperacillin–tazobactam, and 10.4% for carbapenem. Of the patients in the SVPS infection group, 49% were treated with combinations with carbapenem; of the patients in the RVPS infection group, 84.4% were treated in the same way. Central nervous system (CNS) tuberculosis as the etiology of hydrocephalus; short duration of antibiotics used for treatment; high cerebrospinal fluid (CSF) protein and blood C-reactive protein (CRP) levels; and prolonged use of prophylactic antibiotics were found to be related to an increased rate of recurrent infection occurrence. A two-stage shunt change approach decreased the risk of recurrent infections. <b>Conclusions:</b> Based on the findings of our study, it is essential to closely monitor patients with independent risk factors for RVPS infection development, due to the high rates of resistant Gram-negative bacterial growth and the initiation of empirical antimicrobial treatment with glycopeptide plus carbapenem. Certain treatment options, such as 3GCs plus glycopeptide, should be revised based on clinical progress and microbiological culture results.https://www.mdpi.com/2079-6382/14/1/77ventriculoperitoneal shuntinfectionrecurrent VPSresistant Gram-negative bacteriacarbapenem |
| spellingShingle | Neval Elgormus Yusuf Elgormus Bagnu Dundar Fatma Bozkurt Huseyin Dogu Hafize Uzun Management of Recurrent Ventriculoperitoneal Shunt Infections in Adult Patients Antibiotics ventriculoperitoneal shunt infection recurrent VPS resistant Gram-negative bacteria carbapenem |
| title | Management of Recurrent Ventriculoperitoneal Shunt Infections in Adult Patients |
| title_full | Management of Recurrent Ventriculoperitoneal Shunt Infections in Adult Patients |
| title_fullStr | Management of Recurrent Ventriculoperitoneal Shunt Infections in Adult Patients |
| title_full_unstemmed | Management of Recurrent Ventriculoperitoneal Shunt Infections in Adult Patients |
| title_short | Management of Recurrent Ventriculoperitoneal Shunt Infections in Adult Patients |
| title_sort | management of recurrent ventriculoperitoneal shunt infections in adult patients |
| topic | ventriculoperitoneal shunt infection recurrent VPS resistant Gram-negative bacteria carbapenem |
| url | https://www.mdpi.com/2079-6382/14/1/77 |
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