0 shunt infections info..NCC

[Guest guest]

Hi guys...

I'm cleaning out some files and thought that I would pass on some good

information for our members and to have in the archives.

Sally R...Decompression '91... Hydro..VP shunt with 2 revisions...Doing

well, without medication, in Bethlehem,Pa.

>>>

>>> Peroidically I run across new info /abstracts relating to chiari issues

>>> . I thought those with shunt's planed /or present might want to read

>>> /print or bookmark this one from Medscape . I'd consider tracking the

>>> full article down to share with your neurosurgeon ( or requesting he

>>> read it /print to share with you if you want the details too ) --Shunt

>>> infection is a common reason someone may need one removed /or revised

>>> ect and this sounds like a big breaktrhough in helping to prevent them

>>> during surgery through a better grasp on what WILL prevent them from

>>> happening :=) http://www.medscape.com/viewarticle/467512_5

>>>

>>> Neurology/Neurosurgery, January 2004 Journal Scan

>>>

>>> From

>>> Journal of Neurology, Neurosurgery and Psychiatry

>>> January 2004 (Volume 75, Number 1)

>>>

>>>

>>> Zero Tolerance to Shunt Infections: Can It Be Achieved?

>>>

>>> Choksey MS, Malik IA

>>> Journal of Neurology, Neurosurgery and Psychiatry. 2004;75(1):87-91

>>>

>>>

>>> The clinical features of a cerebrospinal fluid (CSF) shunt infection can

>>> be quite variable, and the severity of the infection depends on a

>>> variety of factors, including the pathogenesis of infection, organism

>>> virulence, and type of shunt. The most frequent symptoms are headache,

>>> nausea, lethargy, and change in mental status. Patients with

>>> ventriculoperitoneal shunts and fever should be evaluated promptly for

>>> shunt infection. The most common bacterial pathogen is Staphylococcus

>>> epidermidis. Choksey and Malik reported on their results of 176 shunt

>>> procedures following a strict protocol for shunt placement designed to

>>> eradicate postoperative shunt infections.

>>>

>>> Between 1994 and 2001, 176 shunt procedures were performed in 126

>>> patients with hydrocephalus (93 were primary procedures and 33 were

>>> revisions, some patients required multiple revisions). The majority of

>>> procedures consisted of ventriculoperitoneal shunts, but other shunts

>>> were used, including lumboperitoneal, cystoperitoneal,

>>> ventriculoperitoneal, syringopleural, and ventriculoatrial shunts. A

>>> shunt infection was considered present when a pathogenic organism was

>>> cultured from lumbar or ventricular CSF (or blood) or if the patient

>>> developed pyrexia higher than 38.5 degrees Celsius, shunt malfunction or

>>> abdominal/neurological symptoms. The strict protocol included the use of

>>> intravenous peri- and postoperative antimicrobials, rigid adherence to

>>> classic aseptic techniques, liberal use of a topical antiseptic

>>> (Betadine), and avoidance of hematomas.

>>>

>>> With the use of the strict protocol, shunt infection rates were

>>> significantly reduced. Only 1 infection was documented 7 months

>>> postoperatively (Streptococcus faecalis). The authors concluded shunt

>>> infections could be virtually eliminated by adhering to strict procedure

>>> protocols using antiseptic surgical techniques and prophylactic

>>> antimicrobial therapy.

>>>

>>>