Residual shunt infection in a program aimed at its prevention.

Measures designed to prevent infection after cerebrospinal fluid shunts were described earlier. These include refinements in technique, postponement of operations when there is an actual or threatened leak of cerebrospinal fluid and the use of topical, systemic and intraventricular antibiotics. Six hundred and twenty-four operations in 404 patients, carried out after instituting these precautions were complicated by 13 new infections (2.1%) while in 5 instances (.8%) infection complicated a procedure conducted in the presence of a pre-existant but unrecognized infection. In almost every case the pathogenesis of new infection was clear. The circumstances suggest that some of the residual infections, both new and renewed, might by preventable.