Volume 7 Supplement 1

54th Annual Meeting of the Society for Research into Hydrocephalus and Spina Bifida

Open Access

A retrospective study of infections after primary VP shunt placement in the newborn with Myelomeningocele without prophylactic antibiotics

  • Dorte Clemmensen1Email author,
  • Mikkel Mylius Rasmussen1 and
  • Claus Mosdal1
Cerebrospinal Fluid Research20107(Suppl 1):S43

DOI: 10.1186/1743-8454-7-S1-S43

Published: 15 December 2010

Background

We aim to correlate the frequency of infections after VP shunt placement in neonates with myelomeningocele (MMC) who did not receive prophylactic antibiotics, to the timing of VP shunt placement and the frequency of Cerebrospinal fluid (CSF)leakage at the MMC wound.

Materials and methods

59 newborns with MMC underwent VP shunt insertion in the period 1983-2007. We reviewed retrospectively all records.

Results

The relative risk (RR (95%)) of having an infection is significant higher RR=4,69 (1.145397 -19.23568) (P = .03761817)and neuroinfection showed a tendency towards : RR = 3.5 (.7067445 - 17.03112) (P = .15414095) in newborns without symptomatic Hydrocephalus at birth when we had a wait and watch policy (late shunt placement) compared to newborns with prompt shunt placement. The relative risk (RR 95%) of having a infection was highly significant: RR = 6,8 (3.314154 -13.95228) (P= 1.235e-07) and also neuroinfections RR = 4,76 (2.043019 - 11.09025) ( P = .00044478) if the child presented MMC wound CSF leakage before VP shunt insertion.

Conclusions

Centres with a conservative antibiotic policy should be even more careful to avoid CSF leakage before shunt placement as this gives a highly significant increased risk of both infections in total and neuroinfections and they should reconsider this conservative policy in newborns with MMC due to the significant high infections rate.

Authors’ Affiliations

(1)
Department of Neurosurgery, Aarhus University Hospital

Copyright

© Clemmensen et al; licensee BioMed Central Ltd. 2010

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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