CNS Shunt Infections

PATHOGENS

Commonly implicated pathogens:

• Coagulase-negative staphylococci
• S. aureus
• Streptococcal species
• Propionibacterium species
• Corynebacterium spp.
• Gram-negative bacteria
• Candida species
• Normal skin commensals cause the vast majority of CSF-shunt infections.
  
  • Coagulase-negative staphylococci 40-45%, S. aureus 25%, C. acnes less common (usually less than 8% most series), Corynebacteria/diphtheroids (rare).
    • Biofilm formation is likely an essential role in many infections.
• Patients with CSF shunts have an increased risk of meningitis caused by traditional pathogens (S. pneumoniae, N. meningitidis, H. influenzae); these are often treatable without shunt revision.