{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:25:45Z","timestamp":1790195145778,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,12,10]],"date-time":"2018-12-10T00:00:00Z","timestamp":1544400000000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of this study was to identify independent risk factors for cerebrospinal fluid shunt infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The medical records of all patients aged 0\u201318\u00a0years who underwent shunt\u2010related surgery for the treatment of hydrocephalus at the present institution between January 1996 and December 2015 were reviewed. For each case, two randomly selected controls with no shunt infection, matched for year of surgery, were chosen. Demographic clinical and microbiological data were abstracted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1,570 shunt\u2010related procedures met the inclusion criteria, yielding 68 infections (in 63 patients). The control group consisted of 132 infection\u2010free patients. The average annual infection rate was 4.2% cases per year. The median time between shunt procedures to infection was 19\u00a0days (range, 1\u20132,181). On multivariate analysis, risk factors associated with increased risk for developing an infection included a history of two or more previous revisions (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 4.8; 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.5\u201315.9); and age &lt;5\u00a0years (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 4.5; 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.5\u201313.4). A neoplastic etiology for hydrocephalus was found to be a protective factor for shunt infection (<jats:italic>P<\/jats:italic> = 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A history of shunt revision was the most significant risk factor in the development of subsequent shunt infection. Age &gt;5\u00a0years was a protective factor. Future efforts should focus on modalities to optimize revision procedures and reduce the risk of subsequent infection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.13709","type":"journal-article","created":{"date-parts":[[2018,10,6]],"date-time":"2018-10-06T10:03:27Z","timestamp":1538820207000},"page":"1056-1061","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Risk factors and epidemiology of pediatric ventriculoperitoneal shunt infection"],"prefix":"10.1111","volume":"60","author":[{"given":"Amir","family":"Erps","sequence":"first","affiliation":[{"name":"Pediatric Infectious Disease Unit Tel\u2010Aviv Medical Center Tel Aviv University Tel Aviv Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Roth","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery Dana Children's Hospital Tel\u2010Aviv Medical Center Tel Aviv University Tel Aviv Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shlomi","family":"Constantini","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery Dana Children's Hospital Tel\u2010Aviv Medical Center Tel Aviv University Tel Aviv Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liat","family":"Lerner\u2010Geva","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"},{"name":"Women and Children's Health Research Unit Gertner Institute for Epidemiology and Health Policy Research (Ltd) Tel Hashomer Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9242-9423","authenticated-orcid":false,"given":"Galia","family":"Grisaru\u2010Soen","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease Unit Tel\u2010Aviv Medical Center Tel Aviv University Tel Aviv Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2014.02.013"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/368191"},{"key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1159\/000120557","article-title":"Mechanical complications in shunts","volume":"17","author":"Sainte\u2010Rose C","year":"1991","journal-title":"Pediatr. 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