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Long-term Follow-up of Positive Cultures in 500 Abdominal Aortic Aneurysms
Jean-Christophe Farkas, MD;
Jean-Marc Fichelle, MD;
Claude Laurian, MD;
Alain Jean-Baptiste, MD;
Frederic Gigou, MD;
Jean Marzelle, MD;
Fred W. Goldstein, MD;
Jean-Michel Cormier, MD
Arch Surg. 1993;128(3):284-288.
Abstract
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• Routine aneurysm culture is frequently performed as it is thought that a positive culture could be a risk factor for secondary graft infection. Five hundred aneurysms, in a series of 796 patients, had microbiologic examination of the thrombus and/or aneurysm wall. Cultures were positive in 185 cases (37%), mostly due to normal skin flora microorganisms (80%), whereas 16 patients (3.2%) had infectious aortitis. Gram-stained smears were positive in nine of these 16 patients compared with two of the other 169. Of the 185 patients with positive culture, after a mean length of followup of 35 months, only one had a graft infection that occurred 6 years later and was not due to the same microorganism. Graft sepsis was diagnosed in six of the 296 patients who did not have a positive culture, and was related to clinically obvious locoregional or systemic foci. In this series, positive cultures from aneurysm without rupture or signs of infection were not a risk factor for secondary graft sepsis. Therefore, in cases of asymptomatic unruptured aneurysm, routine culturing is not necessary as a positive result has no pathogenic significance or therapeutic implication.
(Arch Surg. 1993;128:284-288)
Author Affiliations
From the Departments of Vascular Surgery (Drs Farkas, Fichelle, Laurian, Jean-Baptiste, Gigou, Marzelle, and Cormier), and Microbiology (Dr Goldstein), Hôpital Saint Joseph, Paris, France.
Footnotes
Accepted for publication May 16, 1992.
Reprint requests to Intensive Care Unit, Department of Vascular Surgery, Hôpital Saint Joseph, 7, rue Pierre Larousse, 75674 Paris CEDEX 14, France (Dr Farkas).
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