{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:24:14Z","timestamp":1794324254016,"version":"4.9.0"},"reference-count":13,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECT<\/jats:title>\n                    <jats:p>Ventriculoperitoneal shunt (VPS) infections are a major cause of morbidity and mortality in patients with hydrocephalus. Most data about these infections come from the Western literature. Few data about infecting organisms in Africa are available, yet knowledge of these organisms is important for the prevention and treatment of infectious complications. The purpose of this study was to determine the organisms cultured from infected shunts in a rural Kenyan hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors conducted a retrospective study of patients with VPS infections recorded in the neurosurgical database of BethanyKids at Kijabe Hospital between September 2010 and July 2012.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Among 53 VPS infections confirmed by culture, 68% occurred in patients who were younger than 6 months. Seventy-nine percent of the infections occurred within 2 months after shunt insertion. Only 51% of infections were caused by\n                      <jats:italic>Staphylococcus<\/jats:italic>\n                      species (\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      25%, other\n                      <jats:italic>Staphylococcus<\/jats:italic>\n                      species 26%), whereas 40% were caused by gram-negative bacteria. All\n                      <jats:italic>S. aureus<\/jats:italic>\n                      infections and 79% of other\n                      <jats:italic>Staphylococcus<\/jats:italic>\n                      infections were sensitive to cefazolin, but only 1 of 21 gram-negative bacteria was sensitive to it. The majority of gram-negative bacterial infections were multidrug resistant, but 17 of the 20 gram-negative bacteria were sensitive to meropenem. Gram-negative bacterial infections were associated with worse outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>\n                      The high proportion of gram-negative infections differs from data in the Western literature, in which\n                      <jats:italic>Staphylococcus epidermidis<\/jats:italic>\n                      is by far the most common organism. Once a patient is diagnosed with a VPS infection in Kenya, immediate treatment is recommended to cover both gram-positive and gram-negative bacterial infections. Data from other Sub-Saharan countries are needed to determine if those countries have the same increased frequency of gram-negative infections.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2014.10.peds14178","type":"journal-article","created":{"date-parts":[[2014,11,28]],"date-time":"2014-11-28T13:58:42Z","timestamp":1417183122000},"page":"150-155","source":"Crossref","is-referenced-by-count":27,"title":["Bacteria causing ventriculoperitoneal shunt infections in a Kenyan population"],"prefix":"10.3171","volume":"15","author":[{"given":"Naomi","family":"Ochieng'","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, University of Nairobi; and"},{"name":"Department of Surgery, Division of Neurosurgery, Kijabe Hospital, Kijabe, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Humphrey","family":"Okechi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, Kijabe Hospital, Kijabe, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Ferson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, Kijabe Hospital, Kijabe, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Leland","family":"Albright","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, Kijabe Hospital, Kijabe, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds14178","series-title":"Adv Exp Med Biol","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/978-1-4614-0204-6_9","article-title":"Management of shunt related infections","volume":"719","author":"Al-Dabbagh","year":"2011"},{"key":"b2-peds14178","series-title":"Libyan J Med","doi-asserted-by":"publisher","first-page":"20","DOI":"10.3402\/ljm.v3i1.4746","article-title":"Ventriculo-peritoneal shunt infections in infants and children","volume":"3","author":"Bokhary","year":"2008"},{"key":"b3-peds14178","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/BF01411427","article-title":"Risk of infection after cerebrospinal fluid shunt: an analysis of 884 first-time shunts","volume":"136","author":"Borgbjerg","year":"1995"},{"key":"b4-peds14178","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1159\/000070413","article-title":"The influence of surgical operative experience on the duration of first ventriculoperitoneal shunt function and infection","volume":"38","author":"Cochrane","year":"2003"},{"key":"b5-peds14178","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"329","DOI":"10.3171\/2010.7.PEDS09543","article-title":"Outcomes of ventriculoperitoneal shunt insertion in Sub-Saharan Africa","volume":"6","author":"Gathura","year":"2010"},{"key":"b6-peds14178","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"804","DOI":"10.3171\/jns.1979.51.6.0804","article-title":"Long-term analysis of cerebrospinal fluid shunt infections. A 25-year experience","volume":"51","author":"George","year":"1979"},{"key":"b7-peds14178","series-title":"Pediatr Infect Dis J","doi-asserted-by":"publisher","first-page":"e29","DOI":"10.1097\/INF.0b013e3181fe353d","article-title":"Ciprofloxacin use in neonates: a systematic review of the literature","volume":"30","author":"Kaguelidou","year":"2011"},{"key":"b8-peds14178","series-title":"Br J Neurosurg","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1080\/02688690020036801","article-title":"Ventriculoperitoneal shunting in childhood tuberculous meningitis","volume":"15","author":"Lamprecht","year":"2001"},{"key":"b9-peds14178","series-title":"Arq Neuropsiquiatr","first-page":"118","article-title":"[Ventriculoperitoneal shunt infections in children and adolescents with hydrocephalus.]","volume":"65","author":"Lima","year":"2007"},{"key":"b10-peds14178","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000314050","article-title":"Ventriculoperitoneal shunt complications: a three-year retrospective study in a Kenyan national teaching and referral hospital","volume":"46","author":"Mwachaka","year":"2010"},{"key":"b11-peds14178","series-title":"Chilean J Inf","first-page":"38","article-title":"[Risk factors for ventricular peritoneal shunt infection in pediatric patients from the Hospital Carlos Van Buren.]","volume":"29","author":"Pena","year":"2012"},{"key":"b12-peds14178","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"156","DOI":"10.3171\/2009.3.PEDS08215","article-title":"Infection rates following initial cerebrospinal fluid shunt placement across pediatric hospitals in the United States. Clinical article","volume":"4","author":"Simon","year":"2009"},{"key":"b13-peds14178","series-title":"Neurosurgery","first-page":"858","article-title":"Ventriculoperitoneal shunt infections with gram-negative bacteria","volume":"33","author":"Stamos","year":"1993"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/15\/2\/article-p150.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/15\/2\/article-p150.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/15\/2\/article-p150.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T16:06:58Z","timestamp":1681574818000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/15\/2\/article-p150.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2]]},"references-count":13,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2014.10.peds14178","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2]]}}}