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265457

Outcome of Antibiotic-Impregnated Shunt (AIS) Catheters for Management of Hydrocephalus: A Retro-Prospective Study versus Non-AIS Catheters

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Last updated: 22 Jan 2023

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Abstract

Back ground: Ventriculoperitoneal (VP) shunt is one of the most commonly performed procedures by a neurosurgeon. It is occasionally fraught with the most bizarre complications . Shunt infection in hydrocephalus patients  is the  most important complication and causes a severe, even life-threatening complication. Objectives: To evaluate outcome of insertion of antibiotic impregnated shunt (AIS) catheter compared to non-AIS catheter for treatment hydrocephalus (HCP) in neonates. Patients & Methods: Prospective part of the study (Group A) included 50 patients fulfilling the    diagnostic criteria for HCP and assigned to receive AIS catheter. The retrospective part included 50  n patients age- and gender-matched patients underwent non-AIS catheter for treatment of HCP. Study outcomes included rates of catheter-related infection (CRI) and revision surgery (RS) for CRI. Results: Sixteen patients required RS for CRI; 3 in group A and 13 in group B with significantly lower frequency in group A. Frequency of patients required early RS  was significantly lower (p < 0.001) and mean duration till development of the 1st CRI was significantly (p=0.019) longer in group A. Frequency of patients required frequent revision was significantly (p=0.001) lower in group A. Collectively, there were 25 episodes of CRI with significantly lower frequency in group A (p=0.001). Mean number of local CRI findings/patient was significantly (p=0.019) lower and duration of symptoms before diagnosis of CRI was significantly (p=0.02) longer in group A. Thirteen patients showed high leucocytic count, 12 patients had low CSF glucose/serum glucose and  7 patients showed high CSF lactate concentration. Bacteriological examination of replaced catheters showed significantly higher frequency of no bacterial growth in group A, the frequency of catheters positive culture for gram-positive cocci and gram-negative bacilli were significantly lower in group A. Conclusion: AIS catheter allowed significant reduction of CRI and RS rates. CRI rate showed negative significant correlation with age at time of primary surgery. 

DOI

10.21608/bmfj.2022.265457

Keywords

Hydrocephalus, Antibiotic impregnated shunt, catheter-related infection, Revision surgery

Authors

First Name

Ahmed

Last Name

Elsayed Saleh

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Affiliation

Department of Neurosurgery, Benha faculty of medicine, Benha University, Egypt.

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First Name

Islam

Last Name

Abou El Fetoh

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Affiliation

Department of Neurosurgery, Benha faculty of medicine, Benha University, Egypt.

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Volume

40

Article Issue

Special issue (Surgery)

Related Issue

38600

Issue Date

2023-01-01

Receive Date

2022-10-14

Publish Date

2023-01-01

Page Start

1

Page End

14

Print ISSN

1110-208X

Online ISSN

2357-0016

Link

https://bmfj.journals.ekb.eg/article_265457.html

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https://bmfj.journals.ekb.eg/service?article_code=265457

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Original Article

Type Code

787

Publication Type

Journal

Publication Title

Benha Medical Journal

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https://bmfj.journals.ekb.eg/

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Article

Created At

22 Jan 2023