Scobie K, McPhail N, Barber G, Elder R
Can J Surg. 1979 Jul;22(4):368-71.
In patients who undergo abdominal aortic operations, cultures have been recommended perioperatively to identify potential sources of graft infection. Bacteriologic monitoring was done in a group of patients receiving antibiotics prophylactically. Of 197 bowel bag cultures, 28 (14.2%) demonsrated small numbers of bacteria, usually Staphylococcus epidermidis, while of 31 aneurysm wall cultures, 7 (22.6%) grew bacteria. Four (6.6%) of 60 urine cultures done preoperatively indicated a significant bacteriuria, necessitating postponement of elective operations. Twenty-eight (46%) of 61 wounds revealed organisms of low pathogenicity, none of which caused overt infection. While the majority of 63 nasal cultures grew bacteria, this result did not influence the management of any patient. Eleven graft infections occurred in 517 abdominal aortic grafts inserted between 1967 and 1977. In three patients, infection was already present at the time of emergency operation while in another three, infections occurred subsequently, due to paraprosthetic-enteric fistulas in two and septicemia secondary to an operation on the genitourinary tract in the third. In the remaining five patients, no cause for infection was identified. Thus, no bowel bag culture and only one aneurysm wall culture was useful. This study has failed to demonstrate the value of routine cultures perioperatively in patients who undergo abdominal aortic operations.
对于接受腹主动脉手术的患者，建议在围手术期进行培养以确定移植物感染的潜在来源。对一组接受预防性抗生素治疗的患者进行了细菌学监测。在197份肠袋培养物中，28份（14.2%）显示有少量细菌，通常为表皮葡萄球菌，而在31份动脉瘤壁培养物中，7份（22.6%）培养出细菌。术前进行的60份尿培养物中有4份（6.6%）显示有显著菌尿，需要推迟择期手术。61处伤口中有28处（46%）发现致病性低的微生物，均未引起明显感染。虽然63份鼻培养物中的大多数培养出细菌，但这一结果并未影响任何患者的治疗。在1967年至1977年间植入的517个腹主动脉移植物中发生了11例移植物感染。在3例患者中，急诊手术时就已存在感染，另外3例患者随后发生感染，2例是由于人工血管-肠瘘，第3例是由于泌尿生殖道手术后发生败血症。在其余5例患者中，未发现感染原因。因此，没有一份肠袋培养物有用，只有一份动脉瘤壁培养物有用。本研究未能证明在接受腹主动脉手术的患者围手术期进行常规培养的价值。
