[Frequency of bacterial contamination of epidural and plexus catheters in postoperative analgesia]. / Catéteres epidurales y plexulares para analgesia postoperatoria: tasa de contaminación bacteriana.

OBJECTIVE: There is little available information regarding contamination of perineural catheters. Incidence ranges from 5% to 57%, depending on the location of the catheter. The objective of this prospective study was to evaluate the incidence and predisposing factors of bacterial contamination of these catheters. PATIENTS AND METHODS: The study included 47 patients who had an epidural (24 patients) or perineural (23 patients) catheter inserted for a minimum of 48 hours. We recorded details of the patients' characteristics, difficulty of insertion and duration of placement of the catheter, antibiotic treatment received, and signs of local or systemic infection immediately after surgery. When the catheters were removed, cultures were prepared using the Maki method. A descriptive analysis was performed and the frequency of contamination was determined using various parameters. RESULTS: The incidence of contamination was 28% (13 patients): 5/24 (21%) in epidural catheters, 6/17 (35%) in femoral catheters, and 2/6 (33%) in brachial and sciatic plexus catheters. Colonization was not influenced by the patients' characteristics, technical difficulties in placing the catheter, prophylactic antibiotic treatment, or the characteristics of the infusion administered. None of the patients presented clinical signs of infection. The most commonly isolated microorganism was Staphylococcus epidermidis, found in 10 patients (69% of the colonized catheters). CONCLUSIONS: Although infection of perineural catheters is exceptional when they are placed for 2 or more days, contamination is very common. Epidemiological studies are required to evaluate the variables involved.

Catéteres epidurales y plexulares para analgesia postoperatoria: tasa de contaminación bacteriana / Frequency of bacterial contamination of epidural and plexus catheters in postoperative analgesia

OBJETIVOS: Existen pocos datos acerca de la contaminaciónde catéteres dispuestos en posición perineural. Suincidencia se sitúa entre el 5% y el 57% en base a lalocalización del catéter. Planteamos este estudio prospectivo para evaluar la incidencia y factores predisponentes de la contaminación bacteriana de estos.PACIENTES Y MÉTODOS: Se incluyeron 47 pacientes aquienes se les colocó un catéter epidural (24 pacientes) o perineural (23 pacientes) por un periodo mínimo de 48horas. Se recogieron las características de los pacientes, dificultad de inserción y tiempo de colocación del catéter, antibioticoterapia recibida y signos de infección local o sistémica en el postoperatorio inmediato. Tras la retirada delcatéter se realizó el cultivo mediante el método de Maki. Se realizó un análisis descriptivo y se determinó la frecuencia de contaminación en función de distintos parámetros.RESULTADOS: La incidencia de contaminación fue de 13pacientes (28%): 5/24 (21%) en epidurales, 6/17 (35%) enlos femorales y 2/6 (33%) en los plexos braquial y ciático. La colonización no se vio influenciada por las características de los pacientes, las dificultades técnicas en colocación del catéter, la antibioticoterapia profiláctica, ni por las características de la infusión administrada. Ningúnpaciente presentó clínica sugestiva de infección. El microorganismo más frecuentemente aislado fue Staphylococcus epidermidis en 10 pacientes (69% de los colonizados).CONCLUSIONES: Si bien la infección de los catéteresperineurales es excepcional cuando se mantienen durantedos o más días, su contaminación es muy frecuente. Serequieren estudios epidemiológicos amplios para evaluarlas variables implicadas

OBJECTIVE: There is little available informationregarding contamination of perineural catheters. Incidence ranges from 5% to 57%, depending on the location of the catheter. The objective of this prospective study was to evaluate the incidence and predisposing factors of bacterial contamination of these catheters.PATIENTS AND METHODS: The study included 47 patientswho had an epidural (24 patients) or perineural (23patients) catheter inserted for a minimum of 48 hours. Werecorded details of the patients’ characteristics, difficulty of insertion and duration of placement of the catheter, antibiotic treatment received, and signs of local or systemic infection immediately after surgery. When the catheters were removed, cultures were prepared using the Maki method. A descriptive analysis was performed and the frequency of contamination was determined using various parameters.RESULTS: The incidence of contamination was 28% (13patients): 5/24 (21%) in epidural catheters, 6/17 (35%) in femoral catheters, and 2/6 (33%) in brachial and sciatic plexus catheters. Colonization was not influenced by the patients’ characteristics, technical difficulties in placing the catheter, prophylactic antibiotic treatment, or the characteristics of the infusion administered. None of the patients presented clinical signs of infection. The most commonly isolated microorganism was Staphylococcus epidermidis, found in 10 patients (69% of the colonized catheters).CONCLUSIONS: Although infection of perineural cathetersis exceptional when they are placed for 2 or more days,contamination is very common. Epidemiological studies arerequired to evaluate the variables involved