Alqasmi Mohammed, Kariri Yousif A, Alenazy Rawaf, Thabet Mohammed, Fallata Ghaith, Alqurainy Nasser
Department of Medical Laboratory Sciences, College of Applied Medical Sciences-Shaqra, Shaqra University, Shaqra 11961, Saudi Arabia.
Department of Biology, Faculty of Science, Al-Baha University, Al-Baha 65779, Saudi Arabia.
J Clin Med. 2025 Mar 16;14(6):2006. doi: 10.3390/jcm14062006.
Ventriculoperitoneal shunting (VPS) is the primary treatment for hydrocephalus, significantly improving patients' outcomes. However, it is marred by high failure rates due to infections, which account for a third of these malfunctions and escalate morbidity, mortality, and healthcare costs. This study focused on evaluating VPS infection rates, pathogens, their resistance patterns, and the impact on clinical outcomes using retrospective data from multiple hospitals in Saudi Arabia. It included data from hydrocephalus patients who underwent VPS and only considered positive cultures that were confirmed from CSF or shunt tip samples. This study excluded patients with prior infections before VPS placement or those treated with alternatives to VPS. Out of 317 patients who met the inclusion criteria, the analysis revealed that 23 patients (7.26%) suffered from VPS infections, mostly within the first two weeks post-surgery (58.06% of cases), with a significant discrepancy in infection rates between hospitals. Infections predominantly involved Gram-positive bacteria (58.08%), especially coagulase-negative and (25.81% and 12.90%, respectively). There was also a substantial presence of Gram-negative bacteria and fungi, accounting for 35.46% and 6.46%, respectively. Despite general antibiotic susceptibility, resistance was significant in certain cases, including multidrug-resistant isolates like , , and . Importantly, patients with VPS infections had a tenfold increase in the length of hospital stay (70.84 days, SD ± 139.5) compared to non-infected patients (7.69 days, SD ± 20.72), indicating high morbidity and associated treatment costs. Our results emphasize the importance of better VPS infection control and standardized hospital protocols to decrease the incidence of VPS-related infections, both in Saudi Arabia and globally.
脑室腹腔分流术（VPS）是脑积水的主要治疗方法，能显著改善患者的预后。然而，该手术因感染导致的高失败率而存在缺陷，感染占这些故障的三分之一，并会增加发病率、死亡率和医疗成本。本研究利用沙特阿拉伯多家医院的回顾性数据，重点评估VPS感染率、病原体、它们的耐药模式以及对临床结果的影响。研究纳入了接受VPS治疗的脑积水患者的数据，仅考虑脑脊液或分流管尖端样本中确诊的阳性培养物。本研究排除了VPS植入前有既往感染的患者或接受VPS替代治疗的患者。在317例符合纳入标准的患者中，分析显示23例患者（7.26%）发生了VPS感染，大多数发生在术后前两周（占病例的58.06%），各医院之间的感染率存在显著差异。感染主要涉及革兰氏阳性菌（58.08%），尤其是凝固酶阴性葡萄球菌（分别为25.81%和12.90%）。革兰氏阴性菌和真菌也大量存在，分别占35.46%和6.46%。尽管总体上抗生素敏感性良好，但在某些情况下耐药性显著，包括耐多药菌株如[具体菌株名称未给出]、[具体菌株名称未给出]和[具体菌株名称未给出]。重要的是，与未感染患者（7.69天，标准差±20.72）相比，发生VPS感染的患者住院时间延长了十倍（70.84天，标准差±139.5），这表明发病率高且相关治疗成本高。我们的结果强调了在沙特阿拉伯和全球更好地控制VPS感染以及制定标准化医院方案以降低VPS相关感染发生率的重要性。
