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Objective: Ventriculoperitoneal (VP) shunt infections (SIs) remain a significant complication in pediatric neurosurgery, often leading to repeated surgeries and complex intracranial condi tions such as multiloculated hydrocephalus (MH). This retrospective study aimed to evaluate the clinical characteristics, microbiological profiles, and outcomes of pediatric patients with SIs, as well as to identify possible risk factors associated with MH.
Materials and Methods: Medical records of 124 pediatric patients who underwent VP shunt placement between 2018 and 2023 were reviewed. Among them, 29 children developed SIs. Demographic data, cerebrospinal fluid (CSF) parameters, microbiological findings, treatment durations, and surgical interventions were analyzed.
Results: The median age of patients in the infection group was significantly lower compared to the non-infected group (P = .01). Staphylococcus epidermidis was the most frequently isolated microorganism (58.6%). Multiloculated hydrocephalus occurred in 20.6% of patients with SIs, while recurrent and late infections were observed in 27.5% and 20.6% of patients, respectively. Longer treatment duration (P = .035) and the presence of pleocytosis before shunt revision (P = .04) were identified as possible risk factors for developing MH.
Conclusion: The study identified CSF pleocytosis before shunt revision and prolonged treat ment duration as possible risk factors for MH. Younger age has also been found to be a possible risk factor for SI. These findings highlight the importance of recognizing early inflammatory changes in CSF to identify children at risk for this severe complication. Improved risk strati f ication may support more timely interventions and closer follow-up in the management of pediatric SIs.
Cite this article as: Önal P, Vergili E, Apaydın G, et al. Pediatric ventriculoperitoneal shunt infections and the risk of multiloculated hydrocephalus. Turk Arch Pediatr. Published online December 29, 2025. doi:10.5152/TurkArchPediatr.2025.25313