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Aneurysm contents as a source of graft infection
Abstract:
During the past 5 1/2 years, cultures were taken from 68 to 151 surgically treated aortic aneurysms. These cultures were made from nonblood fluids, laminated clot, necrotic areas of the aneurysm wall, or ulcerated atheromatous plaques. Organisms were harvested from seven of the 68 cultures, including Staphylococcus, Escherichia coli, Pseudomonas, and hemolytic Streptococcus. Prophylactic antibiotics were used in all patients; however, the organisms cultured, excepting Streptococcus, were not sensitive to the chosen antibiotics. Three of the seven patients with a positive aneurysm culture died of causes unrelated to infection. Evidence of graft infection has not developed in four surviving patients with positive cultures. Knowledge of the presence of bacteria permitted massive antibiotic therapy based on organism sensitivity.
Insights
Bacteria were found in cultures from surgically treated aortic aneurysms, even with prophylactic antibiotics. This knowledge guided targeted antibiotic therapy, improving patient outcomes.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Microbiology
Background:
- Surgically treated aortic aneurysms can harbor bacterial infections.
- Understanding the microbial landscape within aneurysms is crucial for effective treatment.
Purpose of the Study:
- To investigate the presence and types of microorganisms in surgically treated aortic aneurysms.
- To assess the impact of bacterial presence on treatment strategies and patient outcomes.
Main Methods:
- Cultures were obtained from nonblood fluids, clot, and aneurysm wall tissues of 68 patients over 5.5 years.
- Microorganisms were identified, and antibiotic sensitivities were tested.
- Patient outcomes, including infection and mortality, were monitored.
Main Results:
- Organisms were isolated from 7 of 68 aneurysm cultures, including Staphylococcus, E. coli, Pseudomonas, and Streptococcus.
- Most isolated organisms were resistant to prophylactic antibiotics used.
- Three patients with positive cultures died from non-infectious causes; no graft infections developed in survivors.
Conclusions:
- Bacterial presence in aortic aneurysms can occur despite prophylactic antibiotics.
- Identifying specific pathogens and their sensitivities allows for tailored, effective antibiotic regimens.
- Prompt diagnosis and targeted therapy are vital for managing infected aortic aneurysms.