Frequência de colonização e bactérias isoladas de ponta de cateter de peridural implantado para analgesia pós‐operatória

Stabille, Débora Miranda Diogo; Filho, Augusto Diogo; Mandim, Beatriz Lemos da Silva; Araújo, Lúcio Borges de; Mesquita, Priscila Miranda Diogo; Jorge, Miguel Tanús

doi:10.1016/j.bjan.2014.05.015

Cited by 4 publications

(7 citation statements)

References 33 publications

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“…The reported incidence in the literature varies from 0% to 55%. [ 1 2 3 4 5 6 7 8 9 10 ] This broad variation could be due to the duration of catheter, use of perioperative antibiotics, different methodologies, and patient subsets. [ 7 8 9 10 ]…”

Section: Discussionmentioning

confidence: 99%

“…also proved that use of postoperative epidural analgesia in surgical ward patients, under strict aseptic care, has low risk of bacterial colonization. [ 2 ]…”

Section: Discussionmentioning

confidence: 99%

“…Other studies also have shown it to be the most common pathogen of epidural catheter tip culture. [ 1 2 3 4 5 6 7 8 9 10 11 12 ] Other organisms identified were Escherichia coli 17% (4), Staphylococcus aureus , 4% (1) and Klebsiella 4% (1) of positive culture tips. Among E. coli positive epidural tip patients, 2 were from PACU and 2 from ward and all of them had undergone contaminated lower abdominal surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The possibility of virulent microorganism colonizing epidural catheter is mentioned. [ 1 2 3 4 5 6 7 12 ]…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative epidural analgesia is one of the best pain relief modality with many advantages, but there is a potential for development of epidural infection. [ 1 2 3 4 ] Literature has mentioned the safety of epidural analgesia considering infectious complications time and again; nevertheless, some studies have reported severe complications such as meningitis and epidural abscess. [ 1 2 3 4 5 6 ]…”

Section: Introductionmentioning

confidence: 99%

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A comparative study of epidural catheter colonization and infection in Intensive Care Unit and wards in a Tertiary Care Public Hospital

Harde

Bhadade

Iyer

et al. 2016

Indian Journal of Critical Care Medicine

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Infection is a potentially serious complication of epidural analgesia and with an increase in its use in wards there is a necessity to demonstrate its safety. We aimed to compare the incidence of colonization of epidural catheters retained for short duration (for 48 h) postoperative analgesia in postanesthesia care unit and wards. It was a prospective observational study done in a tertiary care teaching public hospital over a period of 2 years and included 400 patients with 200 each belonged to two groups PACU and ward. We also studied epidural tip culture pattern, skin swab culture at the entry point of the catheter, their relation to each other and whether colonization is equivalent to infection. Data were analyzed using statistical software GraphPad. Overall positive tip culture was 6% (24), of them 7% (14) were from PACU and 5% (10) were from ward (P = 0.5285). Positive skin swab culture was 38% (150), of them 20% (80) were from PACU and 18% (70) were from ward (P = 0.3526). The relation between positive tip culture and positive skin swab culture in same patients is extremely significant showing a strong linear relationship (95% confidence interval = 0.1053–0.2289). The most common microorganism isolated was Staphylococcus epidermidis. No patient had signs of local or epidural infection. There is no difference in the incidence of epidural catheter tip culture and skin swab culture of patients from the general ward and PACU. Epidural analgesia can be administered safely for 48 h in general wards without added risk of infection. The presence of positive tip culture is not a predictor of epidural space infection, and colonization is not equivalent to infection; hence, routine culture is not needed. Bacterial migration from the skin along the epidural track is the most common mode of bacterial colonization; hence, strict asepsis is necessary.

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Section: Discussionmentioning

confidence: 99%

“…also proved that use of postoperative epidural analgesia in surgical ward patients, under strict aseptic care, has low risk of bacterial colonization. [ 2 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The possibility of virulent microorganism colonizing epidural catheter is mentioned. [ 1 2 3 4 5 6 7 12 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A comparative study of epidural catheter colonization and infection in Intensive Care Unit and wards in a Tertiary Care Public Hospital

Harde

Bhadade

Iyer

et al. 2016

Indian Journal of Critical Care Medicine

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Schwangerschafts- und Geburtsrisiken

Neuhaus

Bremerich

2017

Die Geburtshilfliche Anästhesie

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„Why mothers die“

Neuhaus

Fluhr

et al. 2016

Anaesthesist

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Every day, more than 800 women die from causes related to pregnancy or childbirth. Since 1952 the Confidential Enquiry of Maternal Deaths Reports (CEMD) have collected and analysed data on maternal mortality in the United Kingdom and Northern Ireland. This publication analyses the CEMD from 1985-2013 regarding anaesthesia- and analgesia related maternal deaths during pregnancy or peripartum. During this period, there has been a reduction in directly anaesthesia-related maternal deaths to 4.3%. Yet, an increase in anaesthesia-associated maternal deaths has been recorded. The rate of fatal complications during obstetric regional anaesthesia doubled in recent years, while the fatality risk for obstetric general anaesthesia has decreased. Many of the reported maternal deaths could presumably have been avoided. The anaesthesiologist has to be familiar with state-of-the-art, guideline-based concepts for anaesthesia during pregnancy, childbirth or post partum, especially using tools like simulation. Vital sign monitoring after obstetric anaesthesia has to be identical to other postoperative monitoring, and Modified Early Warning Scores should be used for this purpose. In regional anaesthesia, current standards for hygiene have to be adhered to and patients have to be visited after spinal/epidural anaesthesia. Interdisciplinary communication and collaboration still have to be improved; careful interdisciplinary planning of childbirth in high-risk obstetric patients is strongly advised.

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Frequência de colonização e bactérias isoladas de ponta de cateter de peridural implantado para analgesia pós‐operatória

Abstract: Postoperative epidural catheter analgesia, under this study conditions, was found to be low risk for bacterial colonization in patients at surgical wards.

Cited by 4 publications

References 33 publications

A comparative study of epidural catheter colonization and infection in Intensive Care Unit and wards in a Tertiary Care Public Hospital

A comparative study of epidural catheter colonization and infection in Intensive Care Unit and wards in a Tertiary Care Public Hospital

Schwangerschafts- und Geburtsrisiken

„Why mothers die“

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