Shunt infection rates have fallen in recent decades but are still too high, especially when infants under 6 months of age are shunted. The causative bacteria are mainly staphylococci derived from the patient’s skin during operation. Bacteria develop biofilms inside the shunt and this has important implications for treatment. The protective effect of perioperative antibiotic prophylaxis is weak, leading to increased use of antimicrobial shunt catheters, though greater attention to operating room asepsis and antisepsis are at least as important.
Bayston, R. (2018). Cerebrospinal fluid shunt infection: microbiological basis. In M. M. Ozek, C. Sainte-Rose, & G. Cinalli (Eds.), Pediatric hydrocephalus (1-19). Cham: Springer Publishing Company. https://doi.org/10.1007/978-3-319-31889-9_76-1