gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Risk of ventriculo-peritoneal shunt infection in patients with percutaneous gastrostomy

Meeting Abstract

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  • M. Knoop - Klinik für Neurochirurgie, HELIOS Klinikum Bad Saarow
  • M. Schütze - Klinik für Neurochirurgie, Universität Rostock

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocP16-01

DOI: 10.3205/09dgnc422, URN: urn:nbn:de:0183-09dgnc4221

Published: May 20, 2009

© 2009 Knoop et al.
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Outline

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Objective: Percutaneous endoscopic gastrostomy and tracheostomy may be required in neurosurgical patients with a persistently reduced neurological status or severe lower cranial nerve palsies. Such patients may have a coexisting hydrocephalus. Shunt infection is a major complication of shunt implantation. Published data on the incidence of cerebrospinal shunt infection range from 5 to 15 %.

Many prospective studies have documented transient bacteremia of up to 45 % associated with various endoscopic procedures. In normal patients the bacteria are rapidly cleared without sequelae. In patients with xenobiotic material, transient bacteremia can result in colonization of the surface of xenobiotic material. The purpose of this retrospective study is to determine the risk of shunt infections in long-term hospitalized patients with percutaneous endoscopic gastrostomy in whom a ventriculo-peritoneal shunt is placed.

Methods: The patients (n = 47) ranged in age from 18 to 87 years with a mean age of 59.9 years. Prophylactic antibiotics were given prior to ventriculo-peritoneal shunt implantation.

Ventriculo-peritoneal shunts were placed at a minimum of 1 day (range 1 to 157 days) after (n = 25) percutaneous endoscopic gastrostomy and for a minimum of 0 days (range 0 to 87 days) before (n = 22) percutaneous endoscopic gastrostomy.

Results: Within the immediate postoperative period no wound infection or intra-abdominal complications occurred. Five patients (10.6%) developed shunt infection - days 4, 25, 62, 98, and 229.

Conclusions: Ventriculo-peritoneal shunt implantation in long-term hospitalized patients with percutaneous endoscopic gastrostomy and tracheostomy is a procedure with increased risk of infection. Prospective multicenter studies should be carried out to better stratify the risks.