The University of Southampton
University of Southampton Institutional Repository

Direct demonstration of a Staphylococcus biofilm in an external ventricular drain in a patient with a history of recurrent ventriculoperitoneal shunt failure

Stoodley, P., Braxton, Jr. E.E., Nistico, L., Hall-Stoodley, L., Johnson, S., Quigley, M., Post, J.C., Ehrlich, G.D. and Kathju, S. (2010) Direct demonstration of a Staphylococcus biofilm in an external ventricular drain in a patient with a history of recurrent ventriculoperitoneal shunt failure Pediatric Neurosurgery, 46, (2), pp. 127-132. (doi:10.1159/000319396).

Record type: Article


External ventricular drains (EVD) are associated with a high infection rate. Early detection of infection is frequently problematic due to a lack of clinical signs and the time period required for culturing. Bacterial biofilms have been suggested to play an important role in the infection of EVD, but direct evidence is as yet lacking.

We report the case of a 17- year-old male with Dandy-Walker malformation who presented with headache, nausea and drowsiness; a CT scan revealed enlarged ventricles. The patient had a history of ventriculoperitoneal shunt revision 3 weeks prior to admission. The shunt was removed on suspicion of infection and an EVD placed. Daily surveillance cultures through the EVD were negative and the EVD was replaced on day 5. Examination of the initial EVD by confocal microscopy demonstrated clear intraluminal biofilm formation; molecular analysis by PCR identified Staphylococcus aureus resident on the catheter.

To our knowledge, this is the first direct demonstration of an intraluminal biofilm compromising an EVD. Despite the presence of biofilm on this catheter, the patient demonstrated no clinical signs of infection, and the routine surveillance culture was negative. Undetected biofilm may pose a latent risk on EVD and other neurosurgical catheters.

Full text not available from this repository.

More information

Published date: April 2010
Additional Information: Affiliation Paul Stoodley: The National Centre for Advanced Tribology at Southampton (nCATS)
Organisations: Engineering Mats & Surface Engineerg Gp


Local EPrints ID: 149545
ISSN: 1016-2291
PURE UUID: 2feb61b5-daea-4398-82b1-3c484ae3d077

Catalogue record

Date deposited: 30 Jul 2010 08:11
Last modified: 18 Jul 2017 19:26

Export record



Author: P. Stoodley
Author: Jr. E.E. Braxton
Author: L. Nistico
Author: L. Hall-Stoodley
Author: S. Johnson
Author: M. Quigley
Author: J.C. Post
Author: G.D. Ehrlich
Author: S. Kathju

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton:

ePrints Soton supports OAI 2.0 with a base URL of

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.