Prosthetic vascular graft infections between blood and concordance of graft culture pathogen
Related Experiment Video
Updated: May 25, 2026
An In Vitro Model of a Parallel-Plate Perfusion System to Study Bacterial Adherence to Graft Tissues
Published on: January 7, 2019
Naiel Bisharat1, Itamar Minuhin
1Department of Medicine D, Emek Medical Center, Afula, Israel. bisharat_na@clalit.org.il
Introduction:
Prosthetic vascular graft infection (PVGI) is an infrequent and potentially fatal complication of abdominal aortic aneurysm surgery and occlusive vascular disease. The predictive value of blood cultures in accurately identifying the causative pathogen (or pathogens) has not been determined.
Methods:
We studied the compatibility between results of blood and graft cultures obtained from patients suffering from late-onset (>4 months after surgery) infections of abdominal prosthetic vascular grafts.
Results:
Among 17 patients who suffered from late-onset abdominal PVGI, only in 3 patients (17.6%), the same microorganisms isolated from blood cultures were also identified by direct cultures from excised grafts or perigraft tissues. Three patients (17.6%) had negative blood cultures and the rest (n = 11; 64.7%) had different growth of microorganisms from the blood and graft cultures. Three patients were diagnosed with chronic Q fever vascular graft infection, all of whom had positive blood cultures. On the basis of graft cultures, Staphylococcus epidermidis and Escherichia coli were responsible for nearly 50% of cases.
Conclusion:
The yield of blood cultures in late-onset abdominal PVGIs is low. Presence of microorganisms in blood cultures does not necessarily indicate a causal relationship with graft infection. An empirical broad-spectrum antimicrobial therapy is advised in all suspected cases until a definitive etiology has been made.
Insights
Blood cultures have low predictive value for late-onset prosthetic vascular graft infections (PVGI). Microorganisms found in blood may not be the cause of graft infection, necessitating empirical broad-spectrum antimicrobial therapy.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Microbiology
Background:
- Prosthetic vascular graft infection (PVGI) is a rare but serious complication following abdominal aortic aneurysm surgery.
- Accurate identification of causative pathogens via blood cultures in PVGI remains undetermined.
Purpose of the Study:
- To assess the compatibility between blood and graft cultures in patients with late-onset PVGI.
- To determine the diagnostic utility of blood cultures for identifying pathogens in PVGI.
Main Methods:
- Comparison of microbial findings from blood cultures and direct cultures of excised grafts/perigraft tissues.
- Analysis of 17 patients with late-onset (>4 months post-surgery) abdominal PVGI.
Main Results:
- Only 17.6% of patients showed matching microorganisms between blood and graft cultures.
- 64.7% of patients had discordant microbial findings between blood and graft cultures.
- Staphylococcus epidermidis and Escherichia coli were common pathogens identified from graft cultures.
Conclusions:
- Blood cultures have limited diagnostic yield for late-onset abdominal PVGI.
- Positive blood cultures do not always confirm graft infection etiology.
- Empirical broad-spectrum antimicrobial therapy is recommended for suspected PVGI until definitive diagnosis.
Related Concept Videos
01:26Aneurysm III: Interprofessional Care
01:25Hemodialysis I: Introduction
01:25Endocarditis I: Introduction
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin create...
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies. Common...