Predictors of Ventricular Shunt Infection Among Children Presenting to a Pediatric Emergency Department
Pediatric Emergency Care, 05/15/2012
Rogers EA et al. – Among children with a ventricular shunt who had cerebrospinal fluid (CSF) obtained in the emergency department (ED), the presence of recent shunt revision, fever, and leukocytosis was associated with ventricular shunt infection.Methods
- The authors performed a retrospective cohort study of children 3months to 21years of age evaluated in a single pediatric tertiary ED from 1995 to 2008.
- All included children had CSF obtained within 24hours of presentation to the ED.
- A shunt infection was defined by growth of bacteria in the CSF of a child who underwent shunt removal within 7days of presentation.
- Nine hundred seventy-nine children met the inclusion criteria; 130 patients (13%) had growth of bacteria in CSF, of which 58 (5.9% of total) had a shunt infection.
- The median time since last shunt revision or replacement was shorter for patients with a shunt infection compared with children without shunt infection (44 vs 209days, P=0.001).
- After adjustment for patient age, the following factors were associated with shunt infection: shunt revision within the prior 90days (adjusted odds ratio [aOR], 2.4; 95% CI, 1.3–4.4), presence of fever (aOR, 8.4; 95% CI, 4.3–16.3), and white blood cell count greater than 15,000/µL (aOR, 3.2; 95% CI, 1.5–6.6).