Bacterial Contamination of Suction Catheter Tips During Aortic Valve Replacement Surgery: a Prospective Observational Cohort Study

Overview

Journal Patient Saf Surg

Publisher Biomed Central

Date 2015 May 15

PMID 25972923

Citations 1

Authors

Johanna Larsson

Sofia Sutherland

Asa Soderstrom

Christine Roman-Emanuel

Anders Jeppsson

Elisabeth Hansson Olofsson

Per-Arne Svensson

Affiliations

Soon will be listed here.

Abstract

Background: Bacterial mediastinitis is a severe complication after open heart surgery. The infection causes prolonged hospitalization and an increased mortality risk. Observations from orthopaedic surgery showed that the suction catheter used during surgery is commonly contaminated with bacteria. The aim of this study was to describe the prevalence of suction catheter contamination in cardiac surgery and to study if suction time influences the contamination risk.

Methods: Fifty suction catheter tips were collected during 25 aortic valve replacement operations. The suction tip was exchanged once during the operation (after aortotomy closure). The tips were subjected to bacterial contamination analysis.

Results: In 20 of the 25 investigated cases (80%), bacterial contamination was detected on one or both tips. The tip used during the beginning of the operation showed bacterial contamination in 13/25 cases (52%) and the second tip in 12/25 (48%). In 5/25 cases (20%) both tips were contaminated. There was no association between bacterial contamination and suction time. Coagulase-negative staphylococcus was the most commonly detected microorganism.

Conclusions: The suction device should be considered as a potential source of bacterial contamination in cardiac surgery. The results suggest that the suction catheter should be replaced before key moments like valve implantation and sternal closure.

Citing Articles

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Rattanaprichavej P, Laoruengthana A, Galassi M, Weerakul S, Rasamimongkol S Clin Orthop Surg. 2020; 12(1):43-48.

PMID: 32117537 PMC: 7031428. DOI: 10.4055/cios.2020.12.1.43.

References

Meals R, Knoke L . The surgical suction top--a contaminated instrument. J Bone Joint Surg Am. 1978; 60(3):409-10. View

Gardlund B, Bitkover C, Vaage J . Postoperative mediastinitis in cardiac surgery - microbiology and pathogenesis. Eur J Cardiothorac Surg. 2002; 21(5):825-30. DOI: 10.1016/s1010-7940(02)00084-2. View

Klareskov B . Bacteriologic contamination of suction tips during hip arthroplasty. Acta Orthop Scand. 1988; 59(4):410-1. DOI: 10.3109/17453678809149392. View

Owens C, Stoessel K . Surgical site infections: epidemiology, microbiology and prevention. J Hosp Infect. 2008; 70 Suppl 2:3-10. DOI: 10.1016/S0195-6701(08)60017-1. View

Robinson A, Drew S, Anderson J, Bentley G, Ridgway G . Suction tip contamination in the ultraclean-air operating theatre. Ann R Coll Surg Engl. 1993; 75(4):254-6. PMC: 2497922. View

Mulcahy D, McCormack D, McElwain J . Intraoperative suction catheter tip contamination. J R Coll Surg Edinb. 1994; 39(6):371-3. View

Urban J . Cost analysis of surgical site infections. Surg Infect (Larchmt). 2006; 7 Suppl 1:S19-22. DOI: 10.1089/sur.2006.7.s1-19. View

Leaper D, Goor H, Reilly J, Petrosillo N, Geiss H, Torres A . Surgical site infection - a European perspective of incidence and economic burden. Int Wound J. 2006; 1(4):247-73. PMC: 7951634. DOI: 10.1111/j.1742-4801.2004.00067.x. View

Oakley R, Wright J . Postoperative mediastinitis: classification and management. Ann Thorac Surg. 1996; 61(3):1030-6. DOI: 10.1016/0003-4975(95)01035-1. View

10.

Hollenbeak C, Murphy D, Koenig S, Woodward R, Dunagan W, Fraser V . The clinical and economic impact of deep chest surgical site infections following coronary artery bypass graft surgery. Chest. 2000; 118(2):397-402. DOI: 10.1378/chest.118.2.397. View

11.

Greenough C . An investigation into contamination of operative suction. J Bone Joint Surg Br. 1986; 68(1):151-3. DOI: 10.1302/0301-620X.68B1.3510215. View

12.

Kuhme T, Isaksson B, Dahlin L . Wound contamination in cardiac surgery. A systematic quantitative and qualitative study of the bacterial growth in sternal wounds in cardiac surgery patients. APMIS. 2007; 115(9):1001-7. DOI: 10.1111/j.1600-0463.2007.00832.x. View

13.

Givissis P, Karataglis D, Antonarakos P, Symeonidis P, Christodoulou A . Suction during orthopaedic surgery. How safe is the suction tip?. Acta Orthop Belg. 2008; 74(4):531-3. View

14.

Mossad S, Serkey J, Longworth D, Cosgrove 3rd D, Gordon S . Coagulase-negative staphylococcal sternal wound infections after open heart operations. Ann Thorac Surg. 1997; 63(2):395-401. DOI: 10.1016/s0003-4975(96)00834-x. View

15.

Bitkover C, MARCUSSON E, Ransjo U . Spread of coagulase-negative staphylococci during cardiac operations in a modern operating room. Ann Thorac Surg. 2000; 69(4):1110-5. DOI: 10.1016/s0003-4975(99)01432-0. View

16.

Falk-Brynhildsen K, Soderquist B, Friberg O, Nilsson U . Bacterial recolonization of the skin and wound contamination during cardiac surgery: a randomized controlled trial of the use of plastic adhesive drape compared with bare skin. J Hosp Infect. 2013; 84(2):151-8. DOI: 10.1016/j.jhin.2013.02.011. View

17.

Davis N, Curry A, Gambhir A, Panigrahi H, Walker C, Wilkins E . Intraoperative bacterial contamination in operations for joint replacement. J Bone Joint Surg Br. 1999; 81(5):886-9. DOI: 10.1302/0301-620x.81b5.9545. View