# Investigating the types of microorganisms causing cerebrospinal fluid shunt infection in King Abdullah University Hospital in Jordan

## TL;DR

This study examines cerebrospinal fluid shunt infections at a Jordanian hospital, finding Acinetobacter baumannii as the most common cause, especially in children.

## Contribution

The study provides new demographic and microbiological data on CSF shunt infections specific to King Abdullah University Hospital in Jordan.

## Key findings

- Acinetobacter baumannii was the most common pathogen (47.5%) causing CSF shunt infections.
- Pediatric patients had significantly higher rates of recurrent infections compared to adults.
- Infections were strongly associated with congenital anomalies and occurred most frequently within 13 days post-surgery.

## Abstract

Ventriculoperitoneal shunt (VPS) placement treats hydrocephalus by draining excess cerebrospinal fluid (CSF). Despite advances, infections remain a common complication, resulting in significant morbidity and mortality. Infection rates range from 7.2 to 18%, with common pathogens being Staphylococcus epidermidis and Staphylococcus aureus. Risk factors include young age, postoperative CSF leakage, prolonged surgery, and previous infections. The aim of this study was to describe the prevalence of CSF shunt infections at King Abdullah University Hospital (KAUH), assess infection rates in pediatric and adult patients, and report causative microorganisms.

A retrospective analysis was conducted on all patients with CSF shunt-related infections in our hospital (KAUH) over the last 17 years (2005–2023). The patients’ demographics, laboratory results, and details of causative microorganisms were collected.

Of the 579 patients who underwent CSF shunting at KAUH in Jordan, 59 (10.1%) had a positive CSF culture for shunt infection. The majority of the patients were children (83.1%) with a median age of 9 months and a higher proportion of male patients (57.6%). Most of the infections were due to congenital anomalies (74.6%). The median time to infection was 13 days, with 13.5% experiencing recurrent infections. Recurrent infection rates were found to be significantly higher in pediatric patients (p = 0.00007). The most common pathogens were Acinetobacter baumannii (47.5%) and Staphylococcus species (40.7%). Analysis by age group showed a significant association between age and Acinetobacter baumannii infections (p = 0.008).

The study provided demographic and microbiological data on VPS infections, with Acinetobacter baumannii being the most common causative organism. Treatment of these infections remains challenging, highlighting the need for more comparative research on different treatment options.