Microbiology and antimicrobial sensitivity of ventriculo-peritoneal shunt infections in a referral paediatric neurosurgery ward during a period of 7 years

Abstract

Objectives: This study aims to evaluate the aetiology and antibiotic susceptibility pattern in children with ventriculo-peritoneal (VP) shunt infections. Methods: A retrospective investigation was conducted from March 2011 to March 2018 among 163 children, who were admitted because of VP shunt infections in a referral educational hospital in Isfahan, Iran. Results: Coagulase negative staphylococcus (CoNS) was the most common organism (49.0), followed by Acinetobacter baumannii (10.4) and Staphylococcus aureus (8.9). Susceptibility of Gram-positive organisms to a different class of antibiotics was as follows: glycopeptides (82, 96), carbapenems (78.38), aminoglycosides (57.81), fluoroquinolones (50.00) and trimethoprim-sulfamethoxazole (50). Gram-negative isolates were more susceptible to aminoglycosides (56.52) and fluoroquinolones (52.78), respectively. Sensitivity of Gram-negative bacteria to fluoroquinolones was significantly higher in infections that occurred in the first month of the shunt implantations compared to infections that were detected afterward (78.95 vs. 23.53, respectively, P = 0.001). Conclusion: The highest sensitivity of Gram-positive bacteria was to glycopeptides and carbapenems. In addition, Gram-negative organisms had the best susceptibility to aminoglycosides and fluoroquinolones. A high level of resistance to studied antibiotics among Gram-negative isolates underscores the necessity of including new antibiotics such as colistin, fosfomycin, ceftazidime/avibactam, ceftolozane/tazobactam and tigecycline in susceptibility testing and empiric antibiotic therapy for VP shunt infections. (c) 2022 Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )