نبذة مختصرة : Ventriculoperitoneal shunt infection is one of the most dreadful complications of shunt surgery. Though topical, intravenous, and intraventricular antibiotics have been used; the infection rate is still high. It is a retrospective cohort study from Jan 2018 to Dec 2022 in Bangladesh Medical College, performed by a single Neurosurgeon. Objective: To see the effectiveness of the B.M.C.H protocol of shunt surgery in minimizing shunt infection. Method: 83 pediatric Ventriculo Peritoneal shunt cases were selected, who met the inclusion criteria. They were divided into 2 groups. One group had an Ommaya reservoir with or without endoscopic third ventriculostomy (failed) and was subject to cerebrospinal fluid aspiration for a considerable period followed by a shunt. The other group had conventional shunt (non-Ommaya) surgery. Results: The overall infection rate in our hospital in shunt surgery is 3.6%. Among the non-Ommaya or conventional shunt group, it reached 7.1%, while among the Ommaya group, there was not a single shunt infection in the follow-up period. 47% of babies came from the poorest population of the country. There was no significant relationship found between infection with a history of previous infection, per operative use of an endoscope, early age, or preterm birth. Follow up period was between 6 to 18 months. Conclusions: In a non-specialized hospital in a third-world country with limited neurosurgical capacity, following B.M.C.H. protocol, we found the babies who had Ommaya reservoir and underwent regular cerebrospinal fluid aspiration for a period of time before Ventriculo peritoneal shunt surgery were infection free in the long and short time follow up.
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