Duration of in vivo antimicrobial activity of antibiotic-impregnated cerebrospinal fluid catheters

Neurosurgery
Ananthababu PattavilakomAndrew Danks

Abstract

Shunt infection is a major neurosurgical concern even after 50 years of experience with shunt surgery. Staphylococcus species are responsible for the majority of cerebrospinal fluid shunt infections. In vitro, antibiotic-impregnated cerebrospinal fluid shunt catheters (AIC) have demonstrated protection against multiple staphylococcus species and strains for reasonable periods. We aim to study the longevity of antimicrobial activity of AIC in vivo by using explanted catheters. Twenty-five AICs (rifampicin [0.054%] and clindamycin [0.15%]) were explanted from 18 patients for noninfectious reasons, from 11 to 700 days postimplantation. The catheters were set up on standardized Staphylococcus aureus culture plates to detect antimicrobial activity. Unused fresh AIC segments were used as control in each culture plates. Fourteen explanted AICs demonstrated persistent antimicrobial activity against staphylococcal species. Antimicrobial activity was detected for a period of implantation up to 127 days. This is longer than that predicted by in vitro models. The persistent antimicrobial activity is likely to translate to ongoing in vivo antimicrobial protection. This period of protection exceeds that during which most shunt infections occur.

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Citations

Oct 27, 2007·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Caroline HayhurstConor L Mallucci
Oct 19, 2010·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Jothy KandasamyConor Mallucci
Mar 1, 2012·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Derya Burcu HazerTunçalp Ozgen
Nov 3, 2011·Neurocritical Care·Maya A BabuEelco F M Wijdicks
Dec 3, 2011·Journal of Neurosurgery. Pediatrics·Paul KlimoFrederick A Boop
Jun 4, 2008·Journal of Neurosurgery. Pediatrics·Regina EymannMichael Kiefer
Aug 21, 2007·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Benoit J M PirotteJacques Brotchi
Apr 7, 2010·The Journal of Infection·Raquel Gutiérrez-González, Gregorio R Boto
Apr 14, 2007·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Ananthababu PattavilakomR Andrew Danks
Mar 31, 2015·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Giovanni RaffaAntonino Germanò
May 20, 2015·Journal of Neurosurgery. Pediatrics·Paul KlimoUNKNOWN Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force
Aug 15, 2019·The Journal of Antimicrobial Chemotherapy·Roman MounierDavid Lebeaux

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