{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T06:22:36Z","timestamp":1778048556003,"version":"3.51.4"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,9]]},"DOI":"10.7759\/cureus.17035","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T17:10:24Z","timestamp":1628529024000},"source":"Crossref","is-referenced-by-count":1,"title":["Challenges in the Management of Gram-Negative Bacterial Infections in Patients With Ventriculoperitoneal Shunt"],"prefix":"10.7759","author":[{"given":"Faran","family":"Ahmad","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Brubaker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanu S","family":"Rajendraprasad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Hoeynck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brent L","family":"Clyde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manasa","family":"Velagapudi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","reference":[{"key":"ref1","article-title":"Cerebrospinal fluid shunt infections","author":"Adderson EE","year":"2008","unstructured":"Adderson EE, Flynn PM. Cerebrospinal fluid shunt infections. Clinical Infectious Disease. Schlossberg D (ed): Cambridge University Press, Cambridge; 2008. 575."},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2012.27.12.1563","article-title":"Incidence and risk factors of ventriculoperitoneal shunt infections in children: a study of 333 consecutive shunts in 6 years","volume":"27","author":"Lee JK","year":"2012","unstructured":"Lee JK, Seok JY, Lee JH, et al.. Incidence and risk factors of ventriculoperitoneal shunt infections in children: a study of 333 consecutive shunts in 6 years. J Korean Med Sci. 2012, 27:1563-8. 10.3346\/jkms.2012.27.12.1563","journal-title":"J Korean Med Sci"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3171\/2014.10.PEDS14178","article-title":"Bacteria causing ventriculoperitoneal shunt infections in a Kenyan population","volume":"15","author":"Ochieng' N","year":"2015","unstructured":"Ochieng' N, Okechi H, Ferson S, Albright AL. Bacteria causing ventriculoperitoneal shunt infections in a Kenyan population. J Neurosurg Pediatr. 2015, 15:150-5. 10.3171\/2014.10.PEDS14178","journal-title":"J Neurosurg Pediatr"},{"key":"ref4","doi-asserted-by":"crossref","DOI":"10.1016\/S0090-4295(99)00157-0","article-title":"Ventriculoperitoneal shunt infection after bladder augmentation","volume":"54","author":"Pinto K","year":"1999","unstructured":"Pinto K, Jerkins GR, Noe HN. Ventriculoperitoneal shunt infection after bladder augmentation. Urology. 1999, 54:356-8.","journal-title":"Urology"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2011.10.034","article-title":"Ventriculoperitoneal shunt surgery and the risk of shunt infection in patients with hydrocephalus: long-term single institution experience","volume":"78","author":"Reddy GK","year":"2012","unstructured":"Reddy GK, Bollam P, Caldito G. Ventriculoperitoneal shunt surgery and the risk of shunt infection in patients with hydrocephalus: long-term single institution experience. World Neurosurg. 2012, 78:155-63. 10.1016\/j.wneu.2011.10.034","journal-title":"World Neurosurg"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.185408","article-title":"Ventriculoperitoneal shunt tube infection and changing pattern of antibiotic sensitivity in neurosurgery practice: alarming trends","volume":"64","author":"Kumar V","year":"2016","unstructured":"Kumar V, Shah AS, Singh D, Loomba PS, Singh H, Jagetia A. Ventriculoperitoneal shunt tube infection and changing pattern of antibiotic sensitivity in neurosurgery practice: alarming trends. Neurol India. 2016, 64:671-6. 10.4103\/0028-3886.185408","journal-title":"Neurol India"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1097\/NCI.0b013e31827be1d1","article-title":"Ventriculoperitoneal shunt infections in adult patients","volume":"24","author":"Wells DL","year":"2013","unstructured":"Wells DL, Allen JM. Ventriculoperitoneal shunt infections in adult patients. AACN Adv Crit Care. 2013, 24:6-12; quiz 13-4. 10.1097\/NCI.0b013e31827be1d1","journal-title":"AACN Adv Crit Care"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw861","article-title":"2017 Infectious Diseases Society of America's clinical practice guidelines for healthcare-associated ventriculitis and meningitis","volume":"64","author":"Tunkel AR","year":"2017","unstructured":"Tunkel AR, Hasbun R, Bhimraj A, et al.. 2017 Infectious Diseases Society of America's clinical practice guidelines for healthcare-associated ventriculitis and meningitis. Clin Infect Dis. 2017, 64:e34-65. 10.1093\/cid\/ciw861","journal-title":"Clin Infect Dis"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1983.59.3.0389","article-title":"Cerebrospinal fluid shunt infections. A review of 35 infections in 32 patients","volume":"59","author":"Forward KR","year":"1983","unstructured":"Forward KR, Fewer HD, Stiver HG. Cerebrospinal fluid shunt infections. A review of 35 infections in 32 patients. J Neurosurg. 1983, 59:389-94. 10.3171\/jns.1983.59.3.0389","journal-title":"J Neurosurg"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2019.11.029","article-title":"Ventriculoperitoneal shunt infections cause acute abdomen and peritonitis: a case series","volume":"248","author":"Kaestner S","year":"2020","unstructured":"Kaestner S, Fraij A, Fass J, Deinsberger W. Ventriculoperitoneal shunt infections cause acute abdomen and peritonitis: a case series. J Surg Res. 2020, 248:153-8. 10.1016\/j.jss.2019.11.029","journal-title":"J Surg Res"},{"key":"ref11","article-title":"Surgical management of infection of the central nervous system, skull, and spine","author":"Da Silva H","year":"2018","unstructured":"Da Silva H, Coimbra P, Rocha R. Surgical management of infection of the central nervous system, skull, and spine. Principles of Neurological Surgery Fourth. Ellenbogen R, Sekhar L (ed): Elsevier Inc., Amsterdam, Netherlands; 2018. 806-21."},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0b013e318252c23c","article-title":"Predictors of ventricular shunt infection among children presenting to a pediatric emergency department","volume":"28","author":"Rogers EA","year":"2012","unstructured":"Rogers EA, Kimia A, Madsen JR, Nigrovic LE, Neuman MI. Predictors of ventricular shunt infection among children presenting to a pediatric emergency department. Pediatr Emerg Care. 2012, 28:405-9. 10.1097\/PEC.0b013e318252c23c","journal-title":"Pediatr Emerg Care"},{"key":"ref13","unstructured":"NHSN patient safety component manual. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. (2020). Accessed. December 20, 2020: https:\/\/www.cdc.gov\/nhsn\/pdfs\/pscmanual\/pcsmanual_current.pdf."},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.3109\/02688697.2015.1080222","article-title":"Ventriculostomy-related infections: the performance of different definitions for diagnosing infection","volume":"30","author":"Lewis A","year":"2016","unstructured":"Lewis A, Wahlster S, Karinja S, Czeisler BM, Kimberly WT, Lord AS. Ventriculostomy-related infections: the performance of different definitions for diagnosing infection. Br J Neurosurg. 2016, 30:49-56. 10.3109\/02688697.2015.1080222","journal-title":"Br J Neurosurg"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1984.61.2.0328","article-title":"Shunt fluid examination: risks and benefits in the evaluation of shunt malfunction and infection","volume":"61","author":"Noetzel MJ","year":"1984","unstructured":"Noetzel MJ, Baker RP. Shunt fluid examination: risks and benefits in the evaluation of shunt malfunction and infection. J Neurosurg. 1984, 61:328-32. 10.3171\/jns.1984.61.2.0328","journal-title":"J Neurosurg"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.3171\/2014.7.PEDS13612","article-title":"What is the risk of infecting a cerebrospinal fluid-diverting shunt with percutaneous tapping?","volume":"14","author":"Spiegelman L","year":"2014","unstructured":"Spiegelman L, Asija R, Da Silva SL, Krieger MD, McComb JG. What is the risk of infecting a cerebrospinal fluid-diverting shunt with percutaneous tapping?. J Neurosurg Pediatr. 2014, 14:336-9. 10.3171\/2014.7.PEDS13612","journal-title":"J Neurosurg Pediatr"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.3171\/2009.4.PEDS08279","article-title":"How long should cerebrospinal fluid cultures be held to detect shunt infections? Clinical article","volume":"4","author":"Desai A","year":"2009","unstructured":"Desai A, Lollis SS, Missios S, Radwan T, Zuaro DE, Schwarzman JD, Duhaime AC. How long should cerebrospinal fluid cultures be held to detect shunt infections? Clinical article. J Neurosurg Pediatr. 2009, 4:184-9. 10.3171\/2009.4.PEDS08279","journal-title":"J Neurosurg Pediatr"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.3171\/2011.8.PEDS11236","article-title":"Progression of cerebrospinal fluid cell count and differential over a treatment course of shunt infection","volume":"8","author":"Fulkerson DH","year":"2011","unstructured":"Fulkerson DH, Sivaganesan A, Hill JD, Edwards JR, Shoja MM, Boaz JC, Jea A. Progression of cerebrospinal fluid cell count and differential over a treatment course of shunt infection. J Neurosurg Pediatr. 2011, 8:613-9. 10.3171\/2011.8.PEDS11236","journal-title":"J Neurosurg Pediatr"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2014.10.007","article-title":"The diagnostic value of cerebrospinal fluids procalcitonin and lactate for the differential diagnosis of post-neurosurgical bacterial meningitis and aseptic meningitis","volume":"48","author":"Li Y","year":"2015","unstructured":"Li Y, Zhang G, Ma R, et al.. The diagnostic value of cerebrospinal fluids procalcitonin and lactate for the differential diagnosis of post-neurosurgical bacterial meningitis and aseptic meningitis. Clin Biochem. 2015, 48:50-4. 10.1016\/j.clinbiochem.2014.10.007","journal-title":"Clin Biochem"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jped.2017.03.007","article-title":"Cerebrospinal fluid lactate: a differential biomarker for bacterial and viral meningitis in children","volume":"94","author":"Nazir M","year":"2018","unstructured":"Nazir M, Wani WA, Malik MA, Mir MR, Ashraf Y, Kawoosa K, Ali SW. Cerebrospinal fluid lactate: a differential biomarker for bacterial and viral meningitis in children. J Pediatr (Rio J). 2018, 94:88-92. 10.1016\/j.jped.2017.03.007","journal-title":"J Pediatr (Rio J)"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2017.03.021","article-title":"CSF lactate alone is not a reliable indicator of bacterial ventriculitis in patients with ventriculostomies","volume":"157","author":"Hill E","year":"2017","unstructured":"Hill E, Bleck TP, Singh K, Ouyang B, Busl KM. CSF lactate alone is not a reliable indicator of bacterial ventriculitis in patients with ventriculostomies. Clin Neurol Neurosurg. 2017, 157:95-98. 10.1016\/j.clineuro.2017.03.021","journal-title":"Clin Neurol Neurosurg"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e31815f53ba","article-title":"Test characteristics and interpretation of cerebrospinal fluid Gram stain in children","volume":"27","author":"Neuman MI","year":"2008","unstructured":"Neuman MI, Tolford S, Harper MB. Test characteristics and interpretation of cerebrospinal fluid Gram stain in children. Pediatr Infect Dis J. 2008, 27:309-13. 10.1097\/INF.0b013e31815f53ba","journal-title":"Pediatr Infect Dis J"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2019.08.103","article-title":"Evaluation of the BioFire FilmArray meningitis\/encephalitis panel for the detection of bacteria and yeast in Chinese children","volume":"7","author":"Du B","year":"2019","unstructured":"Du B, Hua C, Xia Y, et al.. Evaluation of the BioFire FilmArray meningitis\/encephalitis panel for the detection of bacteria and yeast in Chinese children. Ann Transl Med. 2019, 7:437. 10.21037\/atm.2019.08.103","journal-title":"Ann Transl Med"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1055\/s-2004-817896","article-title":"Distal catheter obstruction from non-infectious cause in ventriculo-peritoneal shunted children","volume":"14","author":"Arnell K","year":"2004","unstructured":"Arnell K, Olsen L. Distal catheter obstruction from non-infectious cause in ventriculo-peritoneal shunted children. Eur J Pediatr Surg. 2004, 14:245-9. 10.1055\/s-2004-817896","journal-title":"Eur J Pediatr Surg"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0000000000002756","article-title":"Progressive hydrocephalus due to ventriculoperitoneal shunt infection: detection with FDG PET CT","volume":"45","author":"Mathew B","year":"2020","unstructured":"Mathew B, Purandare NC, Agrawal A, Shah S, Puranik A, Rangarajan V. Progressive hydrocephalus due to ventriculoperitoneal shunt infection: detection with FDG PET CT. Clin Nucl Med. 2020, 45:e146-7. 10.1097\/RLU.0000000000002756","journal-title":"Clin Nucl Med"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0b013e3181a7d182","article-title":"Ventriculoperitoneal shunt catheter and cerebral spinal fluid infection initially detected by FDG PET\/CT scan","volume":"34","author":"Wan DQ","year":"2009","unstructured":"Wan DQ, Joseph UA, Barron BJ, Caram P, Nguyen AP. Ventriculoperitoneal shunt catheter and cerebral spinal fluid infection initially detected by FDG PET\/CT scan. Clin Nucl Med. 2009, 34:464-5. 10.1097\/RLU.0b013e3181a7d182","journal-title":"Clin Nucl Med"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1086\/425368","article-title":"Practice guidelines for the management of bacterial meningitis","volume":"39","author":"Tunkel AR","year":"2004","unstructured":"Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM, Whitley RJ. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis. 2004, 39:1267-84. 10.1086\/425368","journal-title":"Clin Infect Dis"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0804573","article-title":"Nosocomial bacterial meningitis","volume":"362","author":"van de Beek D","year":"2010","unstructured":"van de Beek D, Drake JM, Tunkel AR. Nosocomial bacterial meningitis. N Engl J Med. 2010, 362:146-54. 10.1056\/NEJMra0804573","journal-title":"N Engl J Med"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199710000-00026","article-title":"Successful meropenem treatment of multiply resistant pneumococcal meningitis","volume":"16","author":"John CC","year":"1997","unstructured":"John CC, Aouad G, Berman B, Schreiber JR. Successful meropenem treatment of multiply resistant pneumococcal meningitis. Pediatr Infect Dis J. 1997, 16:1009-11. 10.1097\/00006454-199710000-00026","journal-title":"Pediatr Infect Dis J"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/32.6.922","article-title":"Meropenem treatment of post-traumatic meningitis due to Pseudomonas aeruginosa","volume":"32","author":"Chmelik V","year":"1993","unstructured":"Chmelik V, Gutvirth J. Meropenem treatment of post-traumatic meningitis due to Pseudomonas aeruginosa. J Antimicrob Chemother. 1993, 32:922-3. 10.1093\/jac\/32.6.922","journal-title":"J Antimicrob Chemother"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199907000-00004","article-title":"Prospective, randomized, investigator-blinded study of the efficacy and safety of meropenem vs. cefotaxime therapy in bacterial meningitis in children. Meropenem Meningitis Study Group","volume":"18","author":"Odio CM","year":"1999","unstructured":"Odio CM, Puig JR, Feris JM, Khan WN, Rodriguez WJ, McCracken GH Jr, Bradley JS. Prospective, randomized, investigator-blinded study of the efficacy and safety of meropenem vs. cefotaxime therapy in bacterial meningitis in children. Meropenem Meningitis Study Group. Pediatr Infect Dis J. 1999, 18:581-90. 10.1097\/00006454-199907000-00004","journal-title":"Pediatr Infect Dis J"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/29.6.719","article-title":"Penetration of rifampicin into the cerebrospinal fluid of adults with uninflamed meninges","volume":"29","author":"Nau R","year":"1992","unstructured":"Nau R, Prange HW, Menck S, Kolenda H, Visser K, Seydel JK. Penetration of rifampicin into the cerebrospinal fluid of adults with uninflamed meninges. J Antimicrob Chemother. 1992, 29:719-24. 10.1093\/jac\/29.6.719","journal-title":"J Antimicrob Chemother"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1080\/02688690042834","article-title":"The management of neurosurgical patients with postoperative bacterial or aseptic meningitis or external ventricular drain-associated ventriculitis","volume":"14","author":"Brown EM","year":"2000","unstructured":"Brown EM, de Louvois J, Bayston R, Lees PD, Pople IK. The management of neurosurgical patients with postoperative bacterial or aseptic meningitis or external ventricular drain-associated ventriculitis. Br J Neurosurg. 2000, 14:7-12. 10.1080\/02688690042834","journal-title":"Br J Neurosurg"},{"key":"ref34","article-title":"Intraventricular antibiotics for bacterial meningitis in neonates","volume":"11","author":"Shah SS","year":"2012","unstructured":"Shah SS, Ohlsson A, Shah VS. Intraventricular antibiotics for bacterial meningitis in neonates. Cochrane Database Syst Rev. 2012, 11:004496.","journal-title":"Cochrane Database Syst Rev"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-012-9784-z","article-title":"Systematic review of efficacy, pharmacokinetics, and administration of intraventricular vancomycin in adults","volume":"20","author":"Ng K","year":"2014","unstructured":"Ng K, Mabasa VH, Chow I, Ensom MH. Systematic review of efficacy, pharmacokinetics, and administration of intraventricular vancomycin in adults. Neurocrit Care. 2014, 20:158-71. 10.1007\/s12028-012-9784-z","journal-title":"Neurocrit Care"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.4103\/2152-7806.103890","article-title":"Management of abdominal pseudocyst in shunt-dependent hydrocephalus","volume":"3","author":"Yuh SJ","year":"2012","unstructured":"Yuh SJ, Vassilyadi M. Management of abdominal pseudocyst in shunt-dependent hydrocephalus. Surg Neurol Int. 2012, 3:146. 10.4103\/2152-7806.103890","journal-title":"Surg Neurol Int"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1974.tb03443.x","article-title":"A study of the sources of infection in colonised shunts","volume":"16","author":"Bayston R","year":"1974","unstructured":"Bayston R, Lari J. A study of the sources of infection in colonised shunts. Dev Med Child Neurol. 1974, 16:16-22. 10.1111\/j.1469-8749.1974.tb03443.x","journal-title":"Dev Med Child Neurol"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-3476(05)83480-8","article-title":"Gram-negative enteric bacillary meningitis: a twenty-one-year experience","volume":"122","author":"Unhanand M","year":"1993","unstructured":"Unhanand M, Mustafa MM, McCracken GH Jr, Nelson JD. Gram-negative enteric bacillary meningitis: a twenty-one-year experience. J Pediatr. 1993, 122:15-21. 10.1016\/s0022-3476(05)83480-8","journal-title":"J Pediatr"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1972.02110120071004","article-title":"The rate of bacteriologic response to antimicrobial therapy in neonatal meningitis","volume":"123","author":"McCracken GH Jr","year":"1972","unstructured":"McCracken GH Jr. The rate of bacteriologic response to antimicrobial therapy in neonatal meningitis. Am J Dis Child. 1972, 123:547-53. 10.1001\/archpedi.1972.02110120071004","journal-title":"Am J Dis Child"},{"key":"ref40","article-title":"Zero tolerance to shunt infections: can it be achieved?","volume":"75","author":"Choksey MS","year":"2004","unstructured":"Choksey MS, Malik IA. Zero tolerance to shunt infections: can it be achieved?. J Neurol Neurosurg Psychiatry. 2004, 75:87-91.","journal-title":"J Neurol Neurosurg Psychiatry"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/64555-challenges-in-the-management-of-gram-negative-bacterial-infections-in-patients-with-ventriculoperitoneal-shunt","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T19:28:54Z","timestamp":1707506934000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/64555-challenges-in-the-management-of-gram-negative-bacterial-infections-in-patients-with-ventriculoperitoneal-shunt"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,9]]},"references-count":40,"URL":"https:\/\/doi.org\/10.7759\/cureus.17035","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2021,8,9]]}}}