{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T02:44:30Z","timestamp":1784861070371,"version":"3.55.0"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2008,5]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Shunt infections represent a major problem with risk for sequelae and even death. The aim in this retrospective study was to analyze the incidence, origin, and clinical presentation of shunt infections, with special reference to the results of cultures for anaerobic organisms performed in addition to the usual tests, to prolonged incubation times, and to infections caused by <jats:italic>Propionibacterium acnes<\/jats:italic>.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The medical records of 237 hydrocephalic children (age range 0\u201315 years) in whom operations were performed by a pediatric surgeon at Uppsala University Hospital during a 13-year period were reviewed.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Thirty-four verified or suspected intraventricular shunt infections and 5 distal catheter infections occurred after 474 operations. Skin bacteria, such as coagulase-negative staphylococci ([CoNS], 19 patients), <jats:italic>Staphylococcus aureus<\/jats:italic> (7 patients), and <jats:italic>P. acnes<\/jats:italic> (6 patients) predominated. The addition of anaerobic cultures and prolonged incubation times increased the verification of shunt infection by more than one third. Children with <jats:italic>P. acnes<\/jats:italic> infection were significantly older, had a lower body temperature, fewer cerebrospinal fluid (CSF) leukocytes, a higher CSF\/blood glucose ratio, more distal catheter infections, and other sources of infection. Four had an abdominal pseudocyst. Children &lt; 1 year of age and infected with CoNS were more affected than older children with systemic and local symptoms. In children with distal catheter infection and growth of propionibacteria at the time of the distal catheter and valve replacement, no follow-up antibiotic treatment was necessary.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Addition of anaerobic cultures and prolonged incubation times led to an increase in the detection of shunt infections. Infections caused by propionibacteria often result in mild symptoms that may be overlooked if adequate anaerobic cultures are not obtained.<\/jats:p><\/jats:sec>","DOI":"10.3171\/ped\/2008\/1\/5\/366","type":"journal-article","created":{"date-parts":[[2008,4,30]],"date-time":"2008-04-30T18:59:40Z","timestamp":1209581980000},"page":"366-372","source":"Crossref","is-referenced-by-count":91,"title":["Cerebrospinal fluid shunt infections in children over a 13-year period: anaerobic cultures and comparison of clinical signs of infection with Propionibacterium acnes and with other bacteria"],"prefix":"10.3171","volume":"1","author":[{"given":"Kai","family":"Arnell","sequence":"first","affiliation":[{"name":"Departments of Pediatric Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Cesarini","sequence":"additional","affiliation":[{"name":"Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Lagerqvist-Widh","sequence":"additional","affiliation":[{"name":"Sections of Clinical Microbiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Wester","sequence":"additional","affiliation":[{"name":"Departments of Pediatric Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Sj\u00f6lin","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3 Suppl","key":"b1-0010366","series-title":"J Neurosurg","first-page":"213","article-title":"Treatment of cerebrospinal fluid shunt infections in children using systemic and intraventricular antibiotic therapy in combination with externalization of the ventricular catheter: efficacy in 34 consecutively treated infections","volume":"107","author":"Arnell","year":"2007"},{"key":"b2-0010366","series-title":"Eur J Pediatr Surg","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1055\/s-2004-817896","article-title":"Distal catheter obstruction from non-infectious cause in ventriculo-peritoneal shunted children","volume":"14","author":"Arnell","year":"2004"},{"issue":"Suppl A","key":"b3-0010366","series-title":"J Antimicrob Chemother","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1093\/jac\/34.suppl_A.75","article-title":"Hydrocephalus shunt infections","volume":"34","author":"Bayston","year":"1994"},{"key":"b4-0010366","series-title":"Am J Med","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1016\/0002-9343(76)90418-6","article-title":"Propionibacterium acnes: pathogen in central nervous system shunt infection. 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