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Infections Complicating Neurosurgical Procedures/Devices

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Abstract

Advances in neurosurgery techniques have prolonged the survival and improved the quality of life of children with otherwise incapacitating diseases such as hydrocephalus, CNS tumors, spasticity, and intractable epilepsy. As with any invasive medical procedure, neurosurgery comes with an attendant risk of infection. One particular challenge in the management of neurosurgical infections in the pediatric population is that patients are often dependent on some form of continued surgical intervention or device (e.g., patients with hydrocephalus often require continued CSF diversion even in the setting of infection). In this chapter we review the medical literature on the epidemiology, clinical features, management, and prevention of infections complicating neurosurgery and neurosurgical devices in children and provide both an infectious diseases and neurosurgical perspective on these problems.

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References

  1. Greenblatt H, Dagi T, Epstein M. A history of neurosurgery. Park Ridge: American Association of Neurological Surgeons Publishing; 1997.

    Google Scholar 

  2. Riva-Cambrin J, Kestle JR, Holubkov R, Butler J, Kulkarni AV, Drake J, et al. Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study. J Neurosurg Pediatr. 2016;17(4):382–90.

    Article  PubMed  Google Scholar 

  3. Schrander-Stumpel C, Fryns JP. Congenital hydrocephalus: nosology and guidelines for clinical approach and genetic counselling. Eur J Pediatr. 1998;157(5):355–62.

    Article  CAS  PubMed  Google Scholar 

  4. Gmeiner M, Wagner H, Zacherl C, Polanski P, Auer C, van Ouwerkerk WJ, et al. Long-term mortality rates in pediatric hydrocephalus-a retrospective single-center study. Childs Nerv Syst. 2017;33(1):101–9.

    Article  PubMed  Google Scholar 

  5. Kulkarni AV, Riva-Cambrin J, Butler J, Browd SR, Drake JM, Holubkov R, et al. Outcomes of CSF shunting in children: comparison of hydrocephalus clinical research network cohort with historical controls: clinical article. J Neurosurg Pediatr. 2013;12(4):334–8.

    Article  PubMed  Google Scholar 

  6. McGirt MJ, Zaas A, Fuchs HE, George TM, Kaye K, Sexton DJ. Risk factors for pediatric ventriculoperitoneal shunt infection and predictors of infectious pathogens. Clin Infect Dis. 2003;36(7):858–62.

    Article  PubMed  Google Scholar 

  7. Lee JK, Seok JY, Lee JH, Choi EH, Phi JH, Kim SK, et al. Incidence and risk factors of ventriculoperitoneal shunt infections in children: a study of 333 consecutive shunts in 6 years. J Korean Med Sci. 2012;27(12):1563–8.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Simon TD, Butler J, Whitlock KB, Browd SR, Holubkov R, Kestle JR, et al. Risk factors for first cerebrospinal fluid shunt infection: findings from a multi-center prospective cohort study. J Pediatr. 2014;164(6):1462–1468.e2.

    Article  PubMed  PubMed Central  Google Scholar 

  9. McGirt MJ, Leveque JC, Wellons JC 3rd, Villavicencio AT, Hopkins JS, Fuchs HE, et al. Cerebrospinal fluid shunt survival and etiology of failures: a seven-year institutional experience. Pediatr Neurosurg. 2002;36(5):248–55.

    Article  PubMed  Google Scholar 

  10. Odio C, McCracken GH Jr, Nelson JD. CSF shunt infections in pediatrics. A seven-year experience. Am J Dis Child. 1984;138(12):1103–8.

    Article  CAS  PubMed  Google Scholar 

  11. Simon TD, Whitlock KB, Riva-Cambrin J, Kestle JR, Rosenfeld M, Dean JM, et al. Revision surgeries are associated with significant increased risk of subsequent cerebrospinal fluid shunt infection. Pediatr Infect Dis J. 2012;31(6):551–6.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Kestle JR, Cochrane DD, Drake JM. Shunt insertion in the summer: is it safe? J Neurosurg. 2006;105(3 Suppl):165–8.

    PubMed  Google Scholar 

  13. Kestle JR, Garton HJ, Whitehead WE, Drake JM, Kulkarni AV, Cochrane DD, et al. Management of shunt infections: a multicenter pilot study. J Neurosurg. 2006;105(3 Suppl):177–81.

    PubMed  Google Scholar 

  14. Kulkarni AV, Rabin D, Lamberti-Pasculli M, Drake JM. Repeat cerebrospinal fluid shunt infection in children. Pediatr Neurosurg. 2001;35(2):66–71.

    Article  CAS  PubMed  Google Scholar 

  15. Tuan TJ, Thorell EA, Hamblett NM, Kestle JR, Rosenfeld M, Simon TD. Treatment and microbiology of repeated cerebrospinal fluid shunt infections in children. Pediatr Infect Dis J. 2011;30(9):731–5.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Simon TD, Mayer-Hamblett N, Whitlock KB, Langley M, Kestle JR, Riva-Cambrin J, et al. Few patient, treatment, and diagnostic or microbiological factors, except complications and intermittent negative cerebrospinal fluid (CSF) cultures during first CSF shunt infection, are associated with reinfection. J Pediatric Infect Dis Soc. 2014;3(1):15–22.

    Article  PubMed  Google Scholar 

  17. Kontny U, Hofling B, Gutjahr P, Voth D, Schwarz M, Schmitt HJ. CSF shunt infections in children. Infection. 1993;21(2):89–92.

    Article  CAS  PubMed  Google Scholar 

  18. Mancao M, Miller C, Cochrane B, Hoff C, Sauter K, Weber E. Cerebrospinal fluid shunt infections in infants and children in mobile, Alabama. Acta Paediatr. 1998;87(6):667–70.

    Article  CAS  PubMed  Google Scholar 

  19. Kestle J, Drake J, Milner R, Sainte-Rose C, Cinalli G, Boop F, et al. Long-term follow-up data from the Shunt Design Trial. Pediatr Neurosurg. 2000;33(5):230–6.

    Article  CAS  PubMed  Google Scholar 

  20. Kestle JR, Riva-Cambrin J, Wellons JC 3rd, Kulkarni AV, Whitehead WE, Walker ML, et al. A standardized protocol to reduce cerebrospinal fluid shunt infection: the hydrocephalus clinical research network quality improvement initiative. J Neurosurg Pediatr. 2011;8(1):22–9.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kestle JR, Holubkov R, Douglas Cochrane D, Kulkarni AV, Limbrick DD Jr, Luerssen TG, et al. A new hydrocephalus clinical research network protocol to reduce cerebrospinal fluid shunt infection. J Neurosurg Pediatr. 2016;17(4):391–6.

    Article  PubMed  Google Scholar 

  22. Davis SE, Levy ML, McComb JG, Masri-Lavine L. Does age or other factors influence the incidence of ventriculoperitoneal shunt infections? Pediatr Neurosurg. 1999;30(5):253–7.

    Article  CAS  PubMed  Google Scholar 

  23. Arnell K, Cesarini K, Lagerqvist-Widh A, Wester T, Sjolin J. Cerebrospinal fluid shunt infections in children over a 13-year period: anaerobic cultures and comparison of clinical signs of infection with Propionibacterium acnes and with other bacteria. J Neurosurg Pediatr. 2008;1(5):366–72.

    Article  PubMed  Google Scholar 

  24. Baird C, O’Connor D, Pittman T. Late shunt infections. Pediatr Neurosurg. 1999;31(5):269–73.

    Article  CAS  PubMed  Google Scholar 

  25. Vinchon M, Lemaitre MP, Vallee L, Dhellemmes P. Late shunt infection: incidence, pathogenesis, and therapeutic implications. Neuropediatrics. 2002;33(4):169–73.

    Article  CAS  PubMed  Google Scholar 

  26. Vallejo JG, Cain AN, Mason EO, Kaplan SL, Hulten KG. Staphylococcus aureus central nervous system infections in children. Pediatr Infect Dis J. 2017;36(10):947–51.

    Article  PubMed  Google Scholar 

  27. Stamos JK, Kaufman BA, Yogev R. Ventriculoperitoneal shunt infections with gram-negative bacteria. Neurosurgery. 1993;33(5):858–62.

    CAS  PubMed  Google Scholar 

  28. Lyke KE, Obasanjo OO, Williams MA, O’Brien M, Chotani R, Perl TM. Ventriculitis complicating use of intraventricular catheters in adult neurosurgical patients. Clin Infect Dis. 2001;33(12):2028–33.

    Article  CAS  PubMed  Google Scholar 

  29. Viraraghavan R, Jantausch B, Campos J. Late-onset central nervous system shunt infections with Propionibacterium acnes: diagnosis and management. Clin Pediatr (Phila). 2004;43(4):393–7.

    Article  Google Scholar 

  30. Konen E. Anaerobic gram-positive nonsporulating bacilli. In: Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. 7th ed. Philadelphia: Elsevier; 2010. p. 3125–8.

    Google Scholar 

  31. Schiff SJ, Oakes WJ. Delayed cerebrospinal-fluid shunt infection in children. Pediatr Neurosci. 1989;15(3):131–5.

    Article  CAS  PubMed  Google Scholar 

  32. Shurtleff DB, Loeser JD, Avellino AM, Duguay S, Englund JA, Marcuse EK, et al. Haemophilus influenzae and Streptococcus pneumoniae infections in children with cerebrospinal fluid shunts. Pediatr Neurosurg. 2009;45(4):276–80.

    Article  CAS  PubMed  Google Scholar 

  33. Schoenbaum SC, Gardner P, Shillito J. Infections of cerebrospinal fluid shunts: epidemiology, clinical manifestations, and therapy. J Infect Dis. 1975;131(5):543–52.

    Article  CAS  PubMed  Google Scholar 

  34. Chiou CC, Wong TT, Lin HH, Hwang B, Tang RB, Wu KG, et al. Fungal infection of ventriculoperitoneal shunts in children. Clin Infect Dis. 1994;19(6):1049–53.

    Article  CAS  PubMed  Google Scholar 

  35. O’Brien D, Stevens NT, Lim CH, O’Brien DF, Smyth E, Fitzpatrick F, et al. Candida infection of the central nervous system following neurosurgery: a 12-year review. Acta Neurochir. 2011;153(6):1347–50.

    Article  PubMed  Google Scholar 

  36. Montero JA, Alrabaa SF, Wills TS. Mycobacterium abscessus ventriculoperitoneal shunt infection and review of the literature. Infection. 2016;44(2):251–3.

    Article  PubMed  Google Scholar 

  37. Cadena G, Wiedeman J, Boggan JE. Ventriculoperitoneal shunt infection with mycobacterium fortuitum: a rare offending organism. J Neurosurg Pediatr. 2014;14(6):704–7.

    Article  PubMed  Google Scholar 

  38. Midani S, Rathore MH. Mycobacterium fortuitum infection of ventriculoperitoneal shunt. South Med J. 1999;92(7):705–7.

    Article  CAS  PubMed  Google Scholar 

  39. Tunkel AR, Hasbun R, Bhimraj A, Byers K, Kaplan SL, Michael Scheld W, et al. 2017 Infectious diseases Society of America’s Clinical Practice Guidelines for healthcare-associated ventriculitis and meningitis. Clin Infect Dis. 2017; 64(6): e34–65.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Rybak M, Lomaestro B, Rotschafer JC, Moellering R Jr, Craig W, Billeter M, et al. Therapeutic monitoring of vancomycin in adult patients: a consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. Am J Health Syst Pharm. 2009;66(1):82–98.

    Article  CAS  PubMed  Google Scholar 

  41. Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ, et al. Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children. Clin Infect Dis. 2011;52(3):e18–55.

    Article  PubMed  Google Scholar 

  42. Yilmaz A, Dalgic N, Musluman M, Sancar M, Colak I, Aydin Y. Linezolid treatment of shunt-related cerebrospinal fluid infections in children. J Neurosurg Pediatr. 2010;5(5):443–8.

    Article  PubMed  Google Scholar 

  43. Cook AM, Ramsey CN, Martin CA, Pittman T. Linezolid for the treatment of a heteroresistant Staphylococcus aureus shunt infection. Pediatr Neurosurg. 2005;41(2):102–4.

    Article  PubMed  Google Scholar 

  44. Kuriakose SS, Rabbat M, Gallagher JC. Ceftaroline CSF concentrations in a patient with ventriculoperitoneal shunt-related meningitis. J Antimicrob Chemother. 2015;​70(3):953–4.

    Article  CAS  PubMed  Google Scholar 

  45. Balouch MA, Bajwa RJ, Hassoun A. Successful use of ceftaroline for the treatment of MRSA meningitis secondary to an infectious complication of lumbar spine surgery. J Antimicrob Chemother. 2015;70(2):624–5.

    Article  CAS  PubMed  Google Scholar 

  46. Gombert ME, Landesman SH, Corrado ML, Stein SC, Melvin ET, Cummings M. Vancomycin and rifampin therapy for Staphylococcus epidermidis meningitis associated with CSF shunts: report of three cases. J Neurosurg. 1981;55(4):633–6.

    Article  CAS  PubMed  Google Scholar 

  47. Vichyanond P, Olson LC. Staphylococcal CNS infections treated with vancomycin and rifampin. Arch Neurol. 1984;41(6):637–9.

    Article  CAS  PubMed  Google Scholar 

  48. Zimmerli W, Widmer AF, Blatter M, Frei R, Ochsner PE. Role of rifampin for treatment of orthopedic implant-related staphylococcal infections: a randomized controlled trial. Foreign-Body Infection (FBI) Study Group. JAMA. 1998;279(19):1537–41.

    Article  CAS  PubMed  Google Scholar 

  49. Foster DR, Rhoney DH. Enterobacter meningitis: organism susceptibilities, antimicrobial therapy and related outcomes. Surg Neurol. 2005;63(6):533–7; discussion 537.

    Article  PubMed  Google Scholar 

  50. Groll AH, Giri N, Petraitis V, Petraitiene R, Candelario M, Bacher JS, et al. Comparative efficacy and distribution of lipid formulations of amphotericin B in experimental Candida albicans infection of the central nervous system. J Infect Dis. 2000;182(1):274–82.

    Article  CAS  PubMed  Google Scholar 

  51. Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, et al. Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):e1–50.

    Article  PubMed  Google Scholar 

  52. Pfausler B, Spiss H, Beer R, Kampl A, Engelhardt K, Schober M, et al. Treatment of staphylococcal ventriculitis associated with external cerebrospinal fluid drains: a prospective randomized trial of intravenous compared with intraventricular vancomycin therapy. J Neurosurg. 2003;98(5):1040–4.

    Article  CAS  PubMed  Google Scholar 

  53. Wang JH, Lin PC, Chou CH, Ho CM, Lin KH, Tsai CT, et al. Intraventricular antimicrobial therapy in postneurosurgical Gram-negative bacillary meningitis or ventriculitis: a hospital-based retrospective study. J Microbiol Immunol Infect. 2014;47(3):204–10.

    Article  CAS  PubMed  Google Scholar 

  54. Tangden T, Enblad P, Ullberg M, Sjolin J. Neurosurgical gram-negative bacillary ventriculitis and meningitis: a retrospective study evaluating the efficacy of intraventricular gentamicin therapy in 31 consecutive cases. Clin Infect Dis. 2011;52(11):1310–6.

    Article  PubMed  CAS  Google Scholar 

  55. Al-Jeraisy M, Phelps SJ, Christensen ML, Einhaus S. Intraventricular vancomycin in pediatric patients with cerebrospinal fluid shunt infections. J Pediatr Pharmacol Ther. 2004;9(1):36–42.

    PubMed  PubMed Central  Google Scholar 

  56. Pickering LK, Ericsson CD, Ruiz-Palacios G, Blevins J, Miner ME. Intraventricular and parenteral gentamicin therapy for ventriculitis in children. Am J Dis Child. 1978;132(5):480–3.

    CAS  PubMed  Google Scholar 

  57. Nakama T, Yamashita S, Hirahara T, Okamoto S, Honda S, Watanabe M, et al. Usefulness of intraventricular infusion of antifungal drugs through Ommaya reservoirs for cryptococcal meningitis treatment. J Neurol Sci. 2015;358(1–2):259–62.

    Article  CAS  PubMed  Google Scholar 

  58. Haase KK, Lapointe M, Haines SJ. Aseptic meningitis after intraventricular administration of gentamicin. Pharmacotherapy. 2001;21(1):103–7.

    Article  CAS  PubMed  Google Scholar 

  59. Remes F, Tomas R, Jindrak V, Vanis V, Setlik M. Intraventricular and lumbar intrathecal administration of antibiotics in postneurosurgical patients with meningitis and/or ventriculitis in a serious clinical state. J Neurosurg. 2013;119(6):1596–602.

    Article  PubMed  Google Scholar 

  60. McCracken GH Jr, Mize SG, Threlkeld N. Intraventricular gentamicin therapy in gram-negative bacillary meningitis of infancy. Report of the Second Neonatal Meningitis Cooperative Study Group. Lancet. 1980;1(8172):787–91.

    PubMed  Google Scholar 

  61. Whitehead WE, Kestle JR. The treatment of cerebrospinal fluid shunt infections. Results from a practice survey of the American Society of Pediatric Neurosurgeons. Pediatr Neurosurg. 2001;35(4):205–10.

    Article  CAS  PubMed  Google Scholar 

  62. Simon TD, Hall M, Dean JM, Kestle JR, Riva-Cambrin J. Reinfection following initial cerebrospinal fluid shunt infection. J Neurosurg Pediatr. 2010;6(3):277–85.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Roitberg BZ, Tomita T, McLone DG. Abdominal cerebrospinal fluid pseudocyst: a complication of ventriculoperitoneal shunt in children. Pediatr Neurosurg. 1998;29(5):267–73.

    Article  CAS  PubMed  Google Scholar 

  64. Gutierrez FA, Raimondi AJ. Peritoneal cysts: a complication of ventriculoperitoneal shunts. Surgery. 1976;79(02):188–92.

    CAS  PubMed  Google Scholar 

  65. Hahn YS, Engelhard H, DG ML. Abdominal CSF pseudocyst. Clinical features and surgical management. Pediatr Neurosci. 1985;12(2):75–9.

    Article  PubMed  Google Scholar 

  66. Vinchon M, Dhellemmes P. Cerebrospinal fluid shunt infection: risk factors and long-term follow-up. Childs Nerv Syst. 2006;22(7):692–7.

    Article  PubMed  Google Scholar 

  67. George R, Leibrock L, Epstein M. Long-term analysis of cerebrospinal fluid shunt infections. A 25-year experience. J Neurosurg. 1979;51(6):804–11.

    Article  CAS  PubMed  Google Scholar 

  68. Walters BC, Hoffman HJ, Hendrick EB, Humphreys RP. Cerebrospinal fluid shunt infection. Influences on initial management and subsequent outcome. J Neurosurg. 1984;60(5):1014–21.

    Article  CAS  PubMed  Google Scholar 

  69. Kulkarni AV, Drake JM, Lamberti-Pasculli M. Cerebrospinal fluid shunt infection: a prospective study of risk factors. J Neurosurg. 2001;94(2):195–201.

    Article  CAS  PubMed  Google Scholar 

  70. Korinek AM. Risk factors for neurosurgical site infections after craniotomy: a prospective multicenter study of 2944 patients. The French study Group of Neurosurgical Infections, the SEHP, and the C-CLIN Paris-Nord. Service Epidemiologie Hygiene et Prevention. Neurosurgery. 1997;41(5):1073–9; discussion 1079–81.

    Article  CAS  PubMed  Google Scholar 

  71. Mollman HD, Haines SJ. Risk factors for postoperative neurosurgical wound infection. A case-control study. J Neurosurg. 1986;64(6):902–6.

    Article  CAS  PubMed  Google Scholar 

  72. Blomstedt GC. Infections in neurosurgery: a retrospective study of 1143 patients and 1517 operations. Acta Neurochir. 1985;78(3–4):81–90.

    Article  CAS  PubMed  Google Scholar 

  73. Campbell E, Beez T, Todd L. Prospective review of 30-day morbidity and mortality in a paediatric neurosurgical unit. Childs Nerv Syst. 2017;33(3):483–9.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Kourbeti IS, Vakis AF, Ziakas P, Karabetsos D, Potolidis E, Christou S, et al. Infections in patients undergoing craniotomy: risk factors associated with post-craniotomy meningitis. J Neurosurg. 2015;122(5):1113–9.

    Article  PubMed  Google Scholar 

  75. Baumeister S, Peek A, Friedman A, Levin LS, Marcus JR. Management of postneurosurgical bone flap loss caused by infection. Plast Reconstr Surg. 2008;122(6):195e–208e.

    Article  PubMed  Google Scholar 

  76. Reichert MC, Medeiros EA, Ferraz FA. Hospital-acquired meningitis in patients undergoing craniotomy: incidence, evolution, and risk factors. Am J Infect Control. 2002;30(3):158–64.

    Article  PubMed  Google Scholar 

  77. McClelland S 3rd, Hall WA. Postoperative central nervous system infection: incidence and associated factors in 2111 neurosurgical procedures. Clin Infect Dis. 2007;45(1):55–9.

    Article  PubMed  Google Scholar 

  78. Bayhan IA, Sees JP, Nishnianidze T, Rogers KJ, Miller F. Infection as a complication of intrathecal baclofen treatment in children with cerebral palsy. J Pediatr Orthop. 2016;36(3):305–9.

    Article  PubMed  Google Scholar 

  79. Motta F, Antonello CE. Analysis of complications in 430 consecutive pediatric patients treated with intrathecal baclofen therapy: 14-year experience. J Neurosurg Pediatr. 2014;13(3):301–6.

    Article  PubMed  Google Scholar 

  80. Vender JR, Hester S, Waller JL, Rekito A, Lee MR. Identification and management of intrathecal baclofen pump complications: a comparison of pediatric and adult patients. J Neurosurg. 2006;104(1 Suppl):9–15.

    PubMed  Google Scholar 

  81. Fjelstad AB, Hommelstad J, Sorteberg A. Infections related to intrathecal baclofen therapy in children and adults: frequency and risk factors. J Neurosurg Pediatr. 2009;4(5):487–93.

    Article  PubMed  Google Scholar 

  82. Spader HS, Bollo RJ, Bowers CA, Riva-Cambrin J. Risk factors for baclofen pump infection in children: a multivariate analysis. J Neurosurg Pediatr. 2016;17(6):756–62.

    Article  PubMed  Google Scholar 

  83. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36(5):309–32.

    Article  PubMed  Google Scholar 

  84. Dickey MP, Rice M, Kinnett DG, Lambert R, Donauer S, Gerber MA, et al. Infectious complications of intrathecal baclofen pump devices in a pediatric population. Pediatr Infect Dis J. 2013;32(7):715–22.

    Article  PubMed  Google Scholar 

  85. Hester SM, Fisher JF, Lee MR, Macomson S, Vender JR. Evaluation of salvage techniques for infected baclofen pumps in pediatric patients with cerebral palsy. J Neurosurg Pediatr. 2012;10(6):548–54.

    Article  PubMed  Google Scholar 

  86. Bennett MI, Tai YM, Symonds JM. Staphylococcal meningitis following Synchromed intrathecal pump implant: a case report. Pain. 1994;56(2):243–4.

    Article  CAS  PubMed  Google Scholar 

  87. Boviatsis EJ, Kouyialis AT, Boutsikakis I, Korfias S, Sakas DE. Infected CNS infusion pumps. Is there a chance for treatment without removal? Acta Neurochir. 2004;146(5):463–7.

    Article  CAS  PubMed  Google Scholar 

  88. Zed PJ, Stiver HG, Devonshire V, Jewesson PJ, Marra F. Continuous intrathecal pump infusion of baclofen with antibiotic drugs for treatment of pump-associated meningitis. Case report. J Neurosurg. 2000;92(2):347–9.

    Article  CAS  PubMed  Google Scholar 

  89. Nichols KR, Knoderer CA, Jackson NG, Manaloor JJ, Christenson JC. Success with extended-infusion meropenem after recurrence of baclofen pump-related achromobacter xylosoxidans meningitis in an adolescent. J Pharm Pract. 2015;28(4):430–3.

    Article  PubMed  Google Scholar 

  90. Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med. 2000;342(5):314–9.

    Article  CAS  PubMed  Google Scholar 

  91. Elliott RE, Rodgers SD, Bassani L, Morsi A, Geller EB, Carlson C, et al. Vagus nerve stimulation for children with treatment-resistant epilepsy: a consecutive series of 141 cases. J Neurosurg Pediatr. 2011;7(5):491–500.

    Article  PubMed  Google Scholar 

  92. Revesz D, Rydenhag B, Ben-Menachem E. Complications and safety of vagus nerve stimulation: 25 years of experience at a single center. J Neurosurg Pediatr. 2016;18(1):97–104.

    Article  PubMed  Google Scholar 

  93. Smyth MD, Tubbs RS, Bebin EM, Grabb PA, Blount JP. Complications of chronic vagus nerve stimulation for epilepsy in children. J Neurosurg. 2003;99(3):500–3.

    Article  PubMed  Google Scholar 

  94. Kahlow H, Olivecrona M. Complications of vagal nerve stimulation for drug-resistant epilepsy: a single center longitudinal study of 143 patients. Seizure. 2013;22(10):827–33.

    Article  PubMed  Google Scholar 

  95. Ortler M, Luef G, Kofler A, Bauer G, Twerdy K. Deep wound infection after vagus nerve stimulator implantation: treatment without removal of the device. Epilepsia. 2001;42(1):133–5.

    Article  CAS  PubMed  Google Scholar 

  96. Patel NC, Edwards MS. Vagal nerve stimulator pocket infections. Pediatr Infect Dis J. 2004;23(7):681–3.

    Article  PubMed  Google Scholar 

  97. Wozniak SE, Thompson EM, Selden NR. Vagal nerve stimulator infection: a lead-salvage protocol. J Neurosurg Pediatr. 2011;7(6):671–5.

    Article  PubMed  Google Scholar 

  98. Barker FG 2nd. Efficacy of prophylactic antibiotics against meningitis after craniotomy: a meta-analysis. Neurosurgery. 2007;60(5):887–94; discussion 887–94.

    Article  PubMed  Google Scholar 

  99. Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013;70(3):195–283.

    Article  CAS  PubMed  Google Scholar 

  100. Alleyne CH Jr, Hassan M, Zabramski JM. The efficacy and cost of prophylactic and perioprocedural antibiotics in patients with external ventricular drains. Neurosurgery. 2000;47(5):1124–7; discussion 1127–9.

    Article  PubMed  Google Scholar 

  101. Poon WS, Ng S, Wai S. CSF antibiotic prophylaxis for neurosurgical patients with ventriculostomy: a randomised study. Acta Neurochir Suppl. 1998;71:146–8.

    CAS  PubMed  Google Scholar 

  102. Sonabend AM, Korenfeld Y, Crisman C, Badjatia N, Mayer SA, Connolly ES Jr. Prevention of ventriculostomy-related infections with prophylactic antibiotics and antibiotic-coated external ventricular drains: a systematic review. Neurosurgery. 2011;68(4):996–1005.

    Article  PubMed  Google Scholar 

  103. Lozier AP, Sciacca RR, Romagnoli MF, Connolly ES Jr. Ventriculostomy-related infections: a critical review of the literature. Neurosurgery. 2008;62(Suppl 2):688–700.

    PubMed  Google Scholar 

  104. O’Hara LM, Thom KA, Preas MA. Update to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infection (2017): a summary, review, and strategies for implementation. Am J Infect Control. 2018;46:602–9.

    Article  PubMed  Google Scholar 

  105. Hommelstad J, Madso A, Eide PK. Significant reduction of shunt infection rate in children below 1 year of age after implementation of a perioperative protocol. Acta Neurochir. 2013;155(3):523–31.

    Article  PubMed  Google Scholar 

  106. Rehman AU, Rehman TU, Bashir HH, Gupta V. A simple method to reduce infection of ventriculoperitoneal shunts. J Neurosurg Pediatr. 2010;5(6):569–72.

    Article  PubMed  Google Scholar 

  107. Tulipan N, Cleves MA. Effect of an intraoperative double-gloving strategy on the incidence of cerebrospinal fluid shunt infection. J Neurosurg. 2006;104(1 Suppl):5–8.

    PubMed  Google Scholar 

  108. Horgan MA, Piatt JH Jr. Shaving of the scalp may increase the rate of infection in CSF shunt surgery. Pediatr Neurosurg. 1997;26(4):180–4.

    Article  CAS  PubMed  Google Scholar 

  109. Ratanalert S, Musikawat P, Oearsakul T, Saeheng S, Chowchuvech V. Non-shaved ventriculoperitoneal shunt in Thailand. J Clin Neurosci. 2005;12(2):147–9.

    Article  PubMed  Google Scholar 

  110. Govender ST, Nathoo N, van Dellen JR. Evaluation of an antibiotic-impregnated shunt system for the treatment of hydrocephalus. J Neurosurg. 2003;99(5):831–9.

    Article  PubMed  Google Scholar 

  111. Zabramski JM, Whiting D, Darouiche RO, Horner TG, Olson J, Robertson C, et al. Efficacy of antimicrobial-impregnated external ventricular drain catheters: a prospective, randomized, controlled trial. J Neurosurg. 2003;98(4):725–30.

    Article  PubMed  Google Scholar 

  112. Parker SL, McGirt MJ, Murphy JA, Megerian JT, Stout M, Engelhart L. Comparative effectiveness of antibiotic-impregnated shunt catheters in the treatment of adult and pediatric hydrocephalus: analysis of 12,589 consecutive cases from 287 US hospital systems. J Neurosurg. 2015;122(2):443–8.

    Article  PubMed  Google Scholar 

  113. Ragel BT, Browd SR, Schmidt RH. Surgical shunt infection: significant reduction when using intraventricular and systemic antibiotic agents. J Neurosurg. 2006;105(2):242–7.

    Article  PubMed  Google Scholar 

  114. Desai VR, Raskin JS, Mohan A, Montojo J, Briceno V, Curry DJ, et al. A standardized protocol to reduce pediatric baclofen pump infections: a quality improvement initiative. J Neurosurg Pediatr. 2018;21(4):395–400.

    Article  PubMed  Google Scholar 

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Whitehead, W., McNeil, J.C. (2019). Infections Complicating Neurosurgical Procedures/Devices. In: McNeil, J., Campbell, J., Crews, J. (eds) Healthcare-Associated Infections in Children. Springer, Cham. https://doi.org/10.1007/978-3-319-98122-2_10

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