硬膜外导管定植与感染无关。

Epidural catheter colonization is not associated with infection.

作者信息

Kostopanagiotou Georgia, Kyroudi Sofia, Panidis Dimitrios, Relia Panagiota, Danalatos Andreas, Smyrniotis Vassilios, Pourgiezi Theodora, Kouskouni Evangelia, Voros Dionyssis

机构信息

Department of Anaesthesiology, University of Athens School of Medicine, Aretaieio Hospital, Athens, Greece.

出版信息

Surg Infect (Larchmt). 2002 Winter;3(4):359-65. doi: 10.1089/109629602762539571.

DOI:10.1089/109629602762539571

PMID:12697082

Abstract

BACKGROUND

Epidural anesthesia is one of the most common types of regional anesthesia. Although retrospective reviews suggest that the incidence of infection from short-term epidural catheter use is exceedingly low in patients undergoing surgery, the correlation between epidural catheter cultures and infection has not been well defined. The purpose of this study was to determine the frequency of bacterial colonization of epidural catheters in adult patients undergoing surgery under epidural anesthesia, as well as the correlation between epidural catheter cultures and infection.

METHODS

A prospective nonrandomized study was conducted over a period of 28 months. The incidence of bacterial contamination after epidural catheterization and the correlation between epidural catheter cultures and infection was investigated for 245 adult ASA I, II patients undergoing surgery under lumbar epidural anesthesia. Catheters were removed when epidural analgesia was no longer required, or if clinical signs of infection or catheter malfunction were present. All epidural catheters were cultured upon withdrawal.

RESULTS

Epidural catheters were kept in place for 2.3 +/- 0.2 days (range 0.1-12 days). Bacteriological analysis of the 245 epidural catheters yielded 28% positive cultures. The most prevalent microorganism was Staphylococcus epidermidis (58%). In obstetric operations a frequency of 32% positive cultures was observed. Neither central nervous system nor systemic infections occurred during the study. No correlations were found among the type of surgery, the type of antibiotic administration, the sex or age of the patients, the duration of catheter placement, the maximum body temperature, and the frequency of positive epidural catheter cultures. There was no correlation between epidural catheter colonization and infection.

CONCLUSION

The contamination of epidural catheters was found to be independent of the administered antimicrobial agents prior to surgery, the duration of catheter placement, and the presence of fever. Except for perioperative prophylaxis, therapeutic use of antibiotics for short-term epidural catheters is not recommended.

摘要

背景

硬膜外麻醉是最常见的区域麻醉类型之一。尽管回顾性研究表明，接受手术的患者短期使用硬膜外导管感染的发生率极低，但硬膜外导管培养与感染之间的相关性尚未明确界定。本研究的目的是确定接受硬膜外麻醉手术的成年患者硬膜外导管细菌定植的频率，以及硬膜外导管培养与感染之间的相关性。

方法

进行了一项为期28个月的前瞻性非随机研究。对245例接受腰段硬膜外麻醉手术的成年ASA I、II级患者，研究硬膜外导管置入后细菌污染的发生率以及硬膜外导管培养与感染之间的相关性。当不再需要硬膜外镇痛时，或出现感染或导管故障的临床体征时，拔除导管。所有硬膜外导管在拔除时均进行培养。

结果

硬膜外导管留置时间为2.3±0.2天（范围0.1 - 12天）。对245根硬膜外导管进行细菌学分析，培养阳性率为28%。最常见的微生物是表皮葡萄球菌（58%）。在产科手术中，观察到培养阳性率为32%。研究期间未发生中枢神经系统或全身感染。在手术类型、抗生素给药类型、患者性别或年龄、导管留置时间、最高体温以及硬膜外导管培养阳性频率之间未发现相关性。硬膜外导管定植与感染之间无相关性。