BACKGROUND There are few published reports of cerebrospinal fluid (CSF) shunt infection outbreaks. In 2017-2018, British Columbia Children's Hospital (BCCH) experienced an increase in CSF shunt infections co-incident with a move to new operating rooms and a change in shunt catheters used. AIMS To describe how an outbreak was detected, investigations were undertaken to determine the cause, risk factors associated with CSF shunt infection during the outbreak, and changes implemented to attempt to control the outbreak. METHODS Retrospective case-control study. Population included patients who underwent new shunt insertion or revision. Univariate logistic regression models were fitted for each of the variables. Associations with P-values <0.2 were considered of potential interest for further investigation. FINDINGS There were six cases of CSF shunt infection and 19 controls. The causative organism was different in each case. The only risk factors that met the criteria for further investigation were being a neonate at the time of surgery [odds ratio (OR) 9.0, 95% confidence interval (CI) 0.7-125.3, P=0.10] and the presence of gastrointestinal disease (OR 3.8, 95% CI 0.5-26.2, P=0.18). No association was found with the operating room used or the surgical staff. In response to the outbreak, human traffic through the operating rooms was limited, rigid adherence to the wearing of surgical masks was enforced, and return to the previous CSF shunt catheters used was implemented. CONCLUSION No modifiable risk factors were associated with CSF shunt infection. After implementation of surgical protocol changes, no further cases of CSF shunt infection linked to the outbreak were identified.

中文翻译：

---

暴发期间脑脊液分流感染的危险因素：病例对照研究。

背景技术很少有关于脑脊液（CSF）分流感染暴发的报道。在2017-2018年期间，不列颠哥伦比亚省儿童医院（BCCH）发生了同时发生的CSF分流感染增加，原因是迁至新的手术室并更换了使用的分流导管。目的为了描述如何检测到暴发，进行了调查以确定原因，暴发期间与CSF分流感染相关的危险因素以及为控制暴发而实施的更改。方法回顾性病例对照研究。人群包括接受新的分流术或翻修术的患者。为每个变量拟合单变量逻辑回归模型。P值<0.2的关联被认为可能需要进一步研究。结果有6例CSF分流感染和19例对照。在每种情况下，致病菌都是不同的。符合进一步检查标准的唯一危险因素是手术时新生儿[几率（OR）9.0、95％置信区间（CI）0.7-125.3，P = 0.10]和胃肠道疾病的存在（或3.8，95％CI 0.5-26.2，P = 0.18）。未发现与所用手术室或手术人员有关联。为应对疫情，限制了通过手术室的人员流量，严格遵守了戴口罩的规定，并恢复了以前使用的CSF分流导管。结论没有可改变的危险因素与脑脊液分流感染有关。实施手术方案变更后，