{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:38:33Z","timestamp":1784867913691,"version":"3.55.0"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T00:00:00Z","timestamp":1728518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R01 NS095979"],"award-info":[{"award-number":["R01 NS095979"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Microbot Medical"},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K24 HL141669"],"award-info":[{"award-number":["K24 HL141669"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health, US","doi-asserted-by":"crossref","award":["P30 DK089507"],"award-info":[{"award-number":["P30 DK089507"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health, US","doi-asserted-by":"crossref","award":["SINGH19R0"],"award-info":[{"award-number":["SINGH19R0"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Shunt infections are a common complication when treating hydrocephalus by cerebrospinal fluid (CSF) shunt placement. The source of infecting pathogens is not well understood. One hypothesis, which we explored here, is that microorganisms persist chronically in the host long before a symptomatic infection occurs and may be detectable in surgical events preceding infection. A cohort of 13 patients was selected, for which CSF samples were available from an infection episode and from a previous surgery event, which was either an initial shunt placement or a revision. Microbiota were analyzed both directly from CSF and from isolates cultured from CSF on aerobic and anaerobic media. The detection and identification of bacteria was done with high throughput DNA sequencing methods and mass spectrometry. The presence of bacteria was confirmed in 4 infection samples, of which 2 were after initial placement and 2 after revision surgery. Taxonomic identification was consistent with clinical microbiology laboratory results. Bacteria were not detected in any of the CSF samples collected at the time of the previous surgical events. While our findings do not provide direct evidence for long-term persistence of pathogens, they suggest the need for consideration of additional source material, such as biofilm and environmental swabs, and\/or the use of more sensitive and specific analytical methods.<\/jats:p>","DOI":"10.1371\/journal.pone.0311605","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T17:22:28Z","timestamp":1728580948000},"page":"e0311605","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["A search for bacteria identified from cerebrospinal fluid shunt infections in previous surgical events"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7770-8347","authenticated-orcid":true,"given":"Paul","family":"Hodor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher E.","family":"Pope","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn B.","family":"Whitlock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J.","family":"McDonald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Hauptman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas R.","family":"Hoffman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D.","family":"Limbrick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara D.","family":"Simon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Cerebrospinal FLuId MicroBiota in Shunts (CLIMB) Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,10,10]]},"reference":[{"key":"pone.0311605.ref001","doi-asserted-by":"crossref","first-page":"883vii","DOI":"10.1016\/S0733-8619(03)00016-1","article-title":"Pediatric hydrocephalus: current management","volume":"21","author":"JR Kestle","year":"2003","journal-title":"Neurologic clinics"},{"key":"pone.0311605.ref002","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.pediatrneurol.2005.05.020","article-title":"Failure of cerebrospinal fluid shunts: part I: Obstruction and mechanical failure","volume":"34","author":"SR Browd","year":"2006","journal-title":"Pediatric neurology"},{"key":"pone.0311605.ref003","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.pediatrneurol.2005.05.021","article-title":"Failure of cerebrospinal fluid shunts: part II: overdrainage, loculation, and abdominal complications","volume":"34","author":"SR Browd","year":"2006","journal-title":"Pediatric neurology"},{"key":"pone.0311605.ref004","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1159\/000055960","article-title":"Long-term follow-up data from the Shunt Design Trial","volume":"33","author":"J Kestle","year":"2000","journal-title":"Pediatric neurosurgery"},{"key":"pone.0311605.ref005","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1542\/peds.59.4.614","article-title":"Gram-negative cerebrospinal fluid shunt-associated infections","volume":"59","author":"CJ Sells","year":"1977","journal-title":"Pediatrics"},{"key":"pone.0311605.ref006","first-page":"866","article-title":"Treatment and prevention of infections of cerebrospinal fluid shunts","volume":"6","author":"P Fan-Havard","year":"1987","journal-title":"Clinical pharmacy"},{"key":"pone.0311605.ref007","first-page":"177","article-title":"Management of shunt infections: a multicenter pilot study","volume":"105","author":"JRW Kestle","year":"2006","journal-title":"Journal of neurosurgery"},{"key":"pone.0311605.ref008","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1159\/000050393","article-title":"Repeat cerebrospinal fluid shunt infection in children","volume":"35","author":"AV Kulkarni","year":"2001","journal-title":"Pediatric neurosurgery"},{"key":"pone.0311605.ref009","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1097\/INF.0b013e318218ac0e","article-title":"Treatment and microbiology of repeated cerebrospinal fluid shunt infections in children","volume":"30","author":"TJ Tuan","year":"2011","journal-title":"The Pediatric infectious disease journal"},{"key":"pone.0311605.ref010","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.3171\/jns.1984.60.5.1014","article-title":"Cerebrospinal fluid shunt infection. 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