Infection following cerebrospinal fluid shunt insertion in the Republic of Ireland A retrospective audit

Results: Ninety-one children underwent 130 CSF shunt insertions, 65 (50%) using clindamycin & rifampicin-impregnated catheters. At admission, 63 (69%) were ≤1 year old and 62 (68%) weighed ≤10 kg. Post-operative infection followed 27 (21%) procedures; 12 episodes of SSI (25% MRSA) and 15 episodes of meningitis (0% MRSA). Eighty-eight percent of culture-positive SSIs were due to S. aureus and 77% of culture-positive meningitis episodes were due to coagulase-negative staphylococci. Average length of stay for infection following CSF shunt insertion was 27 days versus 17 days without. No infection-related deaths were recorded. SSI following shunt revision or replacement following temporary external ventricular drainage (EVD) (9%) was more common than following primary shunt insertion only (5%). Post-operative meningitis occurred in 18% of shunts replaced following EVD versus primary shunt insertion only (11%). Where antimicrobial-impregnated catheters were used, post-operative infection developed in 20% versus 23% for non-antimicrobial-catheters.