Johns Hopkins ABX Guide
CNS Shunt Infections
PATHOGENS
Commonly implicated pathogens:
- Coagulase-negative staphylococci
- S. aureus
- Streptococcal species
- Propionibacterium species
- Corynebacterium spp.
- Gram-negative bacteria
- Candida species
- Normal skin commensals cause the vast majority of CSF-shunt infections.
- Coagulase-negative staphylococci 40-45%, S. aureus 25%, C. acnes less common (usually less than 8% most series), Corynebacteria/diphtheroids (rare).
- Biofilm formation is likely an essential role in many infections.
- Coagulase-negative staphylococci 40-45%, S. aureus 25%, C. acnes less common (usually less than 8% most series), Corynebacteria/diphtheroids (rare).
- Patients with CSF shunts have an increased risk of meningitis caused by traditional pathogens (S. pneumoniae, N. meningitidis, H. influenzae); these are often treatable without shunt revision.
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Last updated: May 13, 2024
Citation
Auwaerter, Paul. "CNS Shunt Infections." Johns Hopkins ABX Guide, The Johns Hopkins University, 2024. Johns Hopkins Guides, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540503/1/CNS_Shunt_Infections.
Auwaerter P. CNS Shunt Infections. Johns Hopkins ABX Guide. The Johns Hopkins University; 2024. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540503/1/CNS_Shunt_Infections. Accessed October 31, 2025.
Auwaerter, P. (2024). CNS Shunt Infections. In Johns Hopkins ABX Guide. The Johns Hopkins University. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540503/1/CNS_Shunt_Infections
Auwaerter P. CNS Shunt Infections [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2024. [cited 2025 October 31]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540503/1/CNS_Shunt_Infections.
* Article titles in AMA citation format should be in sentence-case
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