Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026
Intraventricular treatment experience in children with central nervous system infections.
СтатьяНазвание и аннотация: Перевод в очереди
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Kara Tugce Tural, Tekeli Onur
Аннотация
OBJECTIVES: Ventriculoperitoneal (VP) shunt infections are a significant cause of morbidity and mortality in pediatric neurosurgery. Intraventricular antibiotic administration has emerged as a potential adjunctive treatment, particularly in infections caused by multidrug-resistant organisms (MDR). This study aims to evaluate the efficacy and safety of intraventricular antibiotic therapy in pediatric patients with VP shunt infections.
METHODS: A retrospective review was conducted on pediatric patients (0-18 years) treated with intraventricular antibiotics for VP shunt infections. Data collected included demographic characteristics, causative microorganisms, antibiotic regimens, treatment duration, clinical and microbiological outcomes, complications, and mortality.
RESULTS: Seven patients (nine infection episodes) were included. The most frequently isolated pathogens were Enterococcus faecium, Staphylococcus haemolyticus, and Klebsiella pneumoniae. Intraventricular antibiotics used included colistin, vancomycin, tigecycline, and amikacin. CSF sterilization was achieved in 77.8% of episodes. No neurotoxic adverse effects were observed. The episode-based mortality rate was 33.3% (3/9 episodes), whereas the patient-based mortality rate was 28.6% (2/7 patients).
CONCLUSIONS: Intraventricular antibiotic therapy appears to be an effective and safe adjunct in the management of VP shunt infections, particularly those caused by MDR pathogens. While CSF sterilization was achieved in most cases without neurotoxicity, systemic sepsis and comorbidities remained critical determinants of outcome. Further prospective studies are needed to standardize dosing protocols and optimize therapeutic strategies in this high-risk pediatric population.
METHODS: A retrospective review was conducted on pediatric patients (0-18 years) treated with intraventricular antibiotics for VP shunt infections. Data collected included demographic characteristics, causative microorganisms, antibiotic regimens, treatment duration, clinical and microbiological outcomes, complications, and mortality.
RESULTS: Seven patients (nine infection episodes) were included. The most frequently isolated pathogens were Enterococcus faecium, Staphylococcus haemolyticus, and Klebsiella pneumoniae. Intraventricular antibiotics used included colistin, vancomycin, tigecycline, and amikacin. CSF sterilization was achieved in 77.8% of episodes. No neurotoxic adverse effects were observed. The episode-based mortality rate was 33.3% (3/9 episodes), whereas the patient-based mortality rate was 28.6% (2/7 patients).
CONCLUSIONS: Intraventricular antibiotic therapy appears to be an effective and safe adjunct in the management of VP shunt infections, particularly those caused by MDR pathogens. While CSF sterilization was achieved in most cases without neurotoxicity, systemic sepsis and comorbidities remained critical determinants of outcome. Further prospective studies are needed to standardize dosing protocols and optimize therapeutic strategies in this high-risk pediatric population.