Antibiotic-Impregnated Ventriculoperitoneal Shunts Decrease Bacterial Shunt Infection: A Systematic Review and Meta-Analysis.

Autor:	Kovács J; Centre for Translational Medicine, Semmelweis University, Budapest , Hungary.; Pediatric Center, MTA Center of Excellence, Semmelweis University, Budapest , Hungary., Máté V; Centre for Translational Medicine, Semmelweis University, Budapest , Hungary.; Pediatric Center, MTA Center of Excellence, Semmelweis University, Budapest , Hungary., Obeidat M; Centre for Translational Medicine, Semmelweis University, Budapest , Hungary., Nagy R; Centre for Translational Medicine, Semmelweis University, Budapest , Hungary.; Heim Pál National Pediatric Institute, Budapest , Hungary.; Institute for Translational Medicine, Medical School, University of Pécs, Pécs , Hungary., Agócs G; Centre for Translational Medicine, Semmelweis University, Budapest , Hungary.; Institute of Biophysics and Radiation Biology, Semmelweis University, Budapest , Hungary., Kiss-Dala S; Centre for Translational Medicine, Semmelweis University, Budapest , Hungary., Hegyi P; Centre for Translational Medicine, Semmelweis University, Budapest , Hungary.; Institute for Translational Medicine, Medical School, University of Pécs, Pécs , Hungary.; Institute of Pancreatic Diseases, Semmelweis University, Budapest , Hungary., Kiss-Miki R; Centre for Translational Medicine, Semmelweis University, Budapest , Hungary., Párniczky A; Centre for Translational Medicine, Semmelweis University, Budapest , Hungary.; Heim Pál National Pediatric Institute, Budapest , Hungary., Müller KE; Heim Pál National Pediatric Institute, Budapest , Hungary.; Department of Family Care Methodology, Faculty of Health Sciences, Semmelweis University, Budapest , Hungary., Garami M; Centre for Translational Medicine, Semmelweis University, Budapest , Hungary.; Pediatric Center, MTA Center of Excellence, Semmelweis University, Budapest , Hungary.
Jazyk:	angličtina
Zdroj:	Neurosurgery [Neurosurgery] 2024 Dec 01; Vol. 95 (6), pp. 1263-1273. Date of Electronic Publication: 2024 May 29.
DOI:	10.1227/neu.0000000000003009
Abstrakt:	Background and Objectives: Antibiotic-impregnated shunts seem to be beneficial in preventing bacterial infections and decreasing mortality by effectively inhibiting microbial growth in the shunt system and reducing the risk of shunt-associated infections. This study aimed to evaluate the efficacy of antibiotic-impregnated shunt catheters (AISC) in reducing the incidence of bacterial shunt infection in patients with hydrocephalus. Methods: The protocol was registered on PROSPERO. A meta-analysis was conducted by searching 3 databases (PubMed, Scopus, CENTRAL) for relevant randomized controlled trials and observational studies. We included all studies published until November 2022 in any language. The primary outcome was the rate of bacterial infections, whereas the rate of shunt failure was our secondary endpoint. Odds ratios (OR) with 95% CI were calculated using a random-effects model. Results: A total of 27 articles with 27 266 shunt operations were included in this study. The results indicated that using AISC is significantly associated with reduction in infections (OR = 0.42; 95% CI: 0.33-0.54). Regarding shunt failure, there was a tendency in favor of AISC use (OR = 0.73; 95% CI: 0.51-1.06). Conclusion: Our study provided evidence that AISC is significantly associated with the reduction in the rate of bacterial ventriculoperitoneal-shunt infection. In addition, there was a tendency toward AISC to decrease shunt failure compared with the standard shunt. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Congress of Neurological Surgeons.)
Databáze:	MEDLINE
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