Nosocomial bacterial meningitis, including central nervous system. shunt infections

Nosocomial central nervous system infections primarily consist of nosocomial meningitis and cerebrospinal fluid (CSF) shunt infections. Nosocomial meningitis usually results from a neurosurgical procedure, for example, a postcraniotomy deep wound infection may develop meningitis. Staphylococcus aureus and gram-negative baccilli are the most common agents, and the operative procedure is believed to be the inciting event in CSF shunt infections. In addition, shunts may be infected anywhere along their anatomic course. Systemic or focal signs of infections and evidence of shunt malfunction all should raise the suspicion of CSF shunt infection. Definitive therapy requires both systemic antibiotics and shunt removal. Strategies aimed at decreasing postoperative wound infection rates are Likely to reduce the incidence of nosocomial meningitis but not the risk of shunt infections.