Risk factors for infections associated with the ventriculoperitoneal derivative system in hydrocephalic pediatric patients

Abstract

Introduction: ventriculoperitoneal derivative system is a frequent treatment in hydrocephalus, however, it is exposed to infectious complications, causing high morbidity and mortality in pediatric patients.

Objective: to determinate the risk factors for infection of the ventriculoperitoneal derivative system in hydrocephalic pediatric patients.

Methods: an analytical observational study of cases and controls was carried out in hydrocephalic pediatric patients treated with ventriculoperitoneal derivative system to the Camagüey province between 2010 and 2020, with a universe of 87. Used the absolute and relative percentage frequency, the Chi square independence test and the odds ratio with a 95% confidence interval. 

Results: in 2010, the majority of cases (20,6 %). Male individuals (cases: 31 %; controls: 24,1 %) and individuals under 3 years of age (cases: 55,2 %; controls: 36,2 %) predominated. Concomitant infection, prolonged operative time, previous dysfunction, and untimely antimicrobial prophylaxis were associated (p <0,05) with a higher risk of infection. Intracranial hemorrhage (34,5%) and tumors (31%) prevailed as etiologies of hydrocephalus in cases and controls respectively, sepsis was associated with a higher risk of infection (p = 0,01) and Staphylococcus aureus was isolated in the most cases (31 %).

Conclusions: antimicrobial prophylaxis was the factor that most increased the risk of infections associated with ventriculoperitoneal shunting systems in pediatric patients. The post-sepsis etiology of hydrocephalus was associated with the development of subsequent infections.