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Published on: December 11, 2017
Bacterial contamination of suction catheter tips during aortic valve replacement surgery: a prospective observational
Johanna Larsson1,2, Sofia Sutherland1,2, Åsa Söderström3
1Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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.
Insights
Cardiac surgery suction catheters are frequently contaminated with bacteria, posing a risk for mediastinitis. Replacing the catheter before critical steps like valve implantation may reduce bacterial contamination during open heart surgery.
Area of Science:
- Cardiovascular Surgery
- Infectious Disease Control
- Surgical Microbiology
Background:
- Bacterial mediastinitis is a serious complication following open heart surgery, leading to extended hospital stays and higher mortality.
- Suction catheters in orthopedic surgery have been observed to be a source of bacterial contamination.
- Understanding suction catheter contamination in cardiac surgery is crucial for preventing post-operative infections.
Purpose of the Study:
- To determine the prevalence of bacterial contamination on suction catheters used in cardiac surgery.
- To investigate whether the duration of suction use impacts the risk of catheter contamination.
- To identify common microorganisms found on contaminated suction catheters.
Main Methods:
- Bacterial contamination analysis was performed on 50 suction catheter tips.
- Catheter tips were collected from 25 patients undergoing aortic valve replacement.
- Suction tips were exchanged once during each operation, after aortotomy closure.
Main Results:
- Bacterial contamination was detected on suction catheter tips in 80% of the cases (20 out of 25).
- The first suction tip showed contamination in 52% of cases, and the second tip in 48%.
- No correlation was found between the duration of suction use and the risk of bacterial contamination. Coagulase-negative staphylococcus was the most frequent isolate.
Conclusions:
- Suction devices represent a significant potential source of bacterial contamination in cardiac surgery.
- Replacing suction catheters before critical surgical stages, such as valve implantation and sternal closure, is recommended.
- Implementing strategies to manage suction catheter contamination can aid in reducing surgical site infections.
