کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3039650 1579679 2016 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Efficacy of postoperative antibiotic injection in and around ventriculoperitoneal shunt in reduction of shunt infection: A randomized controlled trial
ترجمه فارسی عنوان
اثربخشی تزریق آنتی بیوتیک پس از عمل در داخل و اطراف شانت بطنی در کاهش عفونت شنت: یک کارآزمایی کنترل شده تصادفی
موضوعات مرتبط
علوم زیستی و بیوفناوری علم عصب شناسی عصب شناسی
چکیده انگلیسی


• Prematurity and age less than one month were risk factors for shunt infection.
• Shunt infection occurred mainly within one month after surgery.
• Vancomycin and gentamicin can be safely injected in and around the shunt.
• Vancomycin and gentamicin shunt injection lowered the rate of shunt infection.

ObjectivesInfection is a common complication of ventriculoperitoneal (VP) shunt surgery. The incidence of shunt infection is still high despite routine administration of perioperative antibiotics. A lower incidence of shunt infection was observed when antibiotic-impregnated shunts (AIS) were used to treat hydrocephalus and a rapid cure was reported in cases of ventriculitis when antibiotics were injected into external ventricular drain (EVD). That is why we theorized that postoperative prophylactic injection of antibiotics in and around the shunt hardware would reduce the incidence of shunt infection.Patients and methodsA randomized controlled clinical trial where 60 patients up to one year old, diagnosed with congenital hydrocephalus and submitted to VP shunt insertion, were randomly assigned to one of 3 groups. The treatment groups received the conventional perioperative antibiotics in addition to vancomycin and gentamicin injection in the reservoir and around the peritoneal catheter either once (group A) or twice (group B), while the control group (C) received only the conventional perioperative antibiotics. Cases were followed-up for up to 1 year.ResultsThe majority of patients were less than 1 month old. The follow-up period ranged from 2 to 12 months with a mean of 8.9 months. The mean duration of onset of infection after surgery was 30 days. Prematurity (p = 0.00236), age less than one month (p < 0.0001) and duration of surgery of 90 min or more (p< 0.00001) were significant risk factors for postoperative shunt infection. Significantly more cases of shunt infection occurred within one month after surgery (p = 0.021). The control group had significantly more cases of postoperative shunt infection than the treatment groups (p = 0.0042).ConclusionsIn congenital hydrocephalus patients submitted to VP shunt insertion, injection of prophylactic vancomycin and gentamicin in and around the shunt hardware significantly reduced the incidence of postoperative shunt infection.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Clinical Neurology and Neurosurgery - Volume 143, April 2016, Pages 144–149
نویسندگان
, ,