ABSTRACT
In this study, the efficacy of ampicillin/sulbactam combination in reactions of periventricular tissue of the lateral ventricle induced by the presence of infected (Staphylococcus epidermidis) silicone rubber shunt tubing was examined by using light and scanning electron microscopy. It was demonstrated that reactive changes to implants had occurred in periventricular tissue in the control group. In infected shunt tubing without given prophylactic antibiotic group, generalized meningitis and ventriculitis, loss of integrity of ependymal cells, numerous inflammatory cells, bacterial colonies, exuda and even pus were seen. It was also shown that rarely inflammatory reactions, minimal disintegration of ependymal cells, no bacterial colonies, and phagocytes were present in the group which was given prophylactic ampicillin/sulbactam combination per and postoperatively. We think that ampicillin/sulbactam combination is very effective in prevention and treatment of shunt infections.
Subject(s)
Ampicillin/therapeutic use , Cerebral Ventricles , Cerebrospinal Fluid Shunts/adverse effects , Encephalitis/drug therapy , Meningitis/drug therapy , Staphylococcal Infections/drug therapy , Staphylococcus epidermidis , Sulbactam/therapeutic use , Ampicillin/administration & dosage , Ampicillin/pharmacology , Animals , Cerebral Ventricles/pathology , Drug Therapy, Combination/administration & dosage , Drug Therapy, Combination/pharmacology , Drug Therapy, Combination/therapeutic use , Encephalitis/etiology , Encephalitis/microbiology , Encephalitis/prevention & control , Equipment Contamination , Humans , Intraoperative Care , Meningitis/etiology , Meningitis/microbiology , Meningitis/prevention & control , Microscopy, Electron, Scanning , Postoperative Care , Rabbits , Staphylococcal Infections/etiology , Staphylococcal Infections/prevention & control , Staphylococcus epidermidis/drug effects , Sulbactam/administration & dosage , Sulbactam/pharmacologyABSTRACT
The reactions of periventricular tissue of the lateral ventricle to non-infected and infected (Staphylococcus Epidermidis) silicone shunt tubing were examined by light and transmission electron microscopy. It was shown that reactive changes occurred in periventricular tissue in response to the implant of sterile shunt tubing. On the other hand in infected implanted silicone shunt tubing, proliferation of inflammatory cells within the ventricle and periventricular tissue, loss of integrity of the ependyma, glial cell proliferation, and excessive extracellular oedema were demonstrated. Proliferation of ependymal cells combined with inflammatory responses may be a factor in the pathogenesis of infected shunt obstruction.
