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尼日利亚埃努古脑室腹腔分流术感染的决定因素与结果

Determinants and outcomes of ventriculoperitoneal shunt infections in Enugu, Nigeria.

作者信息

Uche E O, Onyia E, Mezue U C, Okorie E, Ozor I I, Chikani M C

机构信息

Neurological Surgery Unit, Department of Surgery, College of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria.

出版信息

Pediatr Neurosurg. 2013;49(2):75-80. doi: 10.1159/000357384. Epub 2014 Jan 9.

Abstract

BACKGROUND

To evaluate the determinants and outcomes of shunt infection (SI).

METHODS

One hundred ninety-eight pediatric hydrocephalic patients treated with a ventriculoperitoneal (VP) shunt between January 2008 and August 2012 were retrospectively studied. Patients with SI were compared to those without SI in terms of the occurrence of risk factors and outcomes. Data was analyzed using Statistical Package for the Social Sciences software (version 15).

RESULTS

The age range was 2 weeks to 13 years, with a mean age of 3.1 ± 0.19 years for the SI group versus 2.7 ± 0.2 years for those without SI. One hundred and twelve patients were female and 86 were male. SI was recorded in 17 (8.6%) patients. Postinfective hydrocephalus (n = 6) was the most common cause of hydrocephalus in the SI group. Individuals in the SI group, compared to those without infection, were more likely to be underweight (χ2 = 23.4, p < 0.01). The mean interval between VP shunt placement and SI was 1.83 ± 1.25 months. Coagulase-negative Staphylococcus (29.4%) was the most common pathogen. The mortality rate in our series was 21.4% in patients with SI compared to 2.7% in those without SI.

CONCLUSION

Coagulase-negative Staphylococcus is currently the most common cause of SI and underweight children appear have a higher risk.

摘要

背景

评估分流感染(SI)的决定因素和结果。

方法

回顾性研究2008年1月至2012年8月期间接受脑室腹腔(VP)分流术治疗的198例小儿脑积水患者。将发生SI的患者与未发生SI的患者在危险因素的发生情况和结果方面进行比较。使用社会科学统计软件包(版本15)分析数据。

结果

年龄范围为2周龄至13岁,SI组的平均年龄为3.1±0.19岁,未发生SI的患者平均年龄为2.7±0.2岁。112例患者为女性,86例为男性。17例(8.6%)患者记录有SI。感染后脑积水(n = 6)是SI组中脑积水最常见的原因。与未感染的个体相比,SI组的个体更可能体重不足(χ2 = 23.4,p < 0.01)。VP分流置入与SI之间的平均间隔时间为1.83±1.25个月。凝固酶阴性葡萄球菌(29.4%)是最常见的病原体。我们系列研究中,SI患者的死亡率为21.4%,而未发生SI的患者死亡率为2.7%。

结论

凝固酶阴性葡萄球菌目前是SI最常见的原因,体重不足的儿童似乎风险更高。

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