• Inayatullah Khan
  • Muhammad Burhan
  • Mohammad Nadeem


Background: Central nervous shunt infection (CNSI) is a cause of significant morbidity,causing shunt malfunction and chronic ill health. It can also lead to prolong hospital stay.The aim of this study was to look into the factors responsible for neurosurgical shuntinfection and measures to prevent them. Method: This retrospective case study was donewith nonrandomized convenience sampling. We studied 121 patients who underwentneurosurgical shunt operations during year 1994 to 1999. These patients received pre, perand post operative antibiotics to combat shunt infection. Study design was retrospectivecase study with non randomized convenience sampling. Result: Out of 121 patients, 65patients were females and 56 males. The total number of shunts procedures performed inthese patients was 151. Ninety-seven patients operated once for shunt procedure. Eightythree (83) patients underwent ventriculo-peritoneal shunt, 10 patients underwent lumboperitoneal shunt, 3 had ventriculo-pleural shunt and 1 had ventriculo-atrial shunting done.Three patients developed shunt infection, only one had true primary infection. All wereadults with male to female ratio of 2 to 1 and in all of them shunt was inserted first time.Conclusion: Strict aseptic technique and prophylactic use of antibiotics have critical role inthe prevention of shunt infections.Keywords: CNSI, shunt infection, aseptic technique, and prophylactic antibiotics


Waters BC, Hoffman HJ, Hendrick EB, Humphreys RP. CSF

shunt infection: influences on initial management and

subsequent outcome. J Neurosurg 1984;60:1014–21.

Walters BC, Hoffman HJ, Hendrick EB, Humphreys RP.

Decreased risk of infection in CSF shunt surgery using

prophylactic antibiotics, a case control study. Z Kinderchir

; 40(suppl 1):15–8.

Overton MC, Snodgrass SR. Ventriculo-venous shunts for

infantile hydrocephalus. A review of five years’ experience

with this method. J Neurosurg 1965;23:517.

J Ayub Med Coll Abbottabad 2009;21(1)


Schoenbaum SC, Gardne P, Shilotto J. Infections of

cerebrospinal fluid shunts: epidemiology, clinical

manifestations and therapy. J Infect Dis 1975;131:543–52.

Choux M, Genitori I, Lang D, Lena G. Shunt implantation:

reducing the incidence of shunt infection. J Neurosurg


Moll Man HD, Haines SJ. Risk factors for postoperative

neurosurgical wound infection. A case control study. J

Neurosurg 1986;64(6):902–6.

Wang KW, Chang WN, Shih TY, Huang CR, Tsai NW,

Chang CS, et al. Infection of cerebrospinal fluid shunts:

causative pathogens clinical features, and outcomes. Jpn J

Infect Dis 2004;57(2):44–8.

Kestle JR. Garton HJ, Whitehead WE, Drake JM, Kulkarani

AV, Cochrane DD, et al. Management of shunt infection. J

Neurosurg 2006;105(3 suppl):177–81.

Conen A ,Walti LN, Merlo A, Fluckiger U, Battegay M,

Trampuz A. Charateristics and treatment outcome of

cerebrospinal fluid shunt-associated infections in adults: a

retrospective analysis over an 11-year period. Clin Infect Dis


Brown EM, Edwards RJ, Pople IK. Conservative

management of patients with cerebrospinal fluid shunt

infections. Neurosurgery. 2006;58(4):657–65; discussion