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Direct Demonstration of Staphylococcus Biofilm in an External Ventricular Drain in a Patient with a History of Recurrent Ventriculoperitoneal Shunt Failure
Journal article   Open access   Peer reviewed

Direct Demonstration of Staphylococcus Biofilm in an External Ventricular Drain in a Patient with a History of Recurrent Ventriculoperitoneal Shunt Failure

Paul Stoodley, Ernest E Braxton, Laura Nistico, Luanne Hall-Stoodley, Sandra Johnson, Matthew Quigley, J. Christopher Post, Garth D Ehrlich and Sandeep Kathju
Pediatric neurosurgery, v 46(2), pp 127-132
Aug 2010
PMID: 20664301
url
https://doi.org/10.1159/000319396View
Published, Version of Record (VoR) Open

Abstract

Biofilm Confocal microscopy Ventriculoperitoneal shunt External ventricular drain Staphylococcus Case Report
External ventricular drains (EVD) are associated with a high infection rate. Early detection of infection is frequently problematic due to a lack of clinical signs and the time period required for culturing. Bacterial biofilms have been suggested to play an important role in the infection of EVD, but direct evidence is as yet lacking. We report the case of a 17- year-old male with Dandy-Walker malformation who presented with headache, nausea and drowsiness; a CT scan revealed enlarged ventricles. The patient had a history of ventriculoperitoneal shunt revision 3 weeks prior to admission. The shunt was removed on suspicion of infection and an EVD placed. Daily surveillance cultures through the EVD were negative and the EVD was replaced on day 5. Examination of the initial EVD by confocal microscopy demonstrated clear intraluminal biofilm formation; molecular analysis by PCR identified Staphylococcus aureus resident on the catheter. To our knowledge, this is the first direct demonstration of an intraluminal biofilm compromising an EVD. Despite the presence of biofilm on this catheter, the patient demonstrated no clinical signs of infection, and the routine surveillance culture was negative. Undetected biofilm may pose a latent risk on EVD and other neurosurgical catheters.

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Domestic collaboration
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Web of Science research areas
Clinical Neurology
Pediatrics
Surgery
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