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The microbiology of explanted vascular prostheses
H W Kaebnick1, D F Bandyk, T W Bergamini
1Department of Surgery, Medical College of Wisconsin, Milwaukee.
Surgery
|October 1, 1987
Summary
Bacterial colonization is common in vascular grafts, particularly Staphylococcus epidermidis. Even with high colonization rates, grafts can remain infection-free, suggesting low-virulence bacteria may cause late complications like aneurysms.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Microbiology
Background:
- Prosthetic vascular grafts are susceptible to bacterial colonization.
- Graft complications like aneurysms and thrombosis necessitate revision surgery.
Purpose of the Study:
- To determine the incidence and type of bacterial colonization in explanted vascular grafts.
- To investigate the association between specific bacteria, biofilm formation, and graft complications.
Main Methods:
- Explanted vascular grafts from 44 patients were cultured using ultrasonic disruption of biofilms.
- Microorganisms were identified, and slime production by Staphylococcus epidermidis was assessed.
- Correlation between bacterial findings and graft complications (aneurysm vs. thrombosis) was analyzed.
Main Results:
- Bacterial colonization was found in 90% of grafts with anastomotic aneurysms and 69% of thrombosed grafts.
- Staphylococcus epidermidis was the most prevalent organism (69% of isolates).
- Slime-producing S. epidermidis strains were more common in grafts with pseudoaneurysms (87%) than thrombosed grafts (33%).
Conclusions:
- Low-virulence bacteria, such as Staphylococcus epidermidis, can colonize vascular prostheses without causing overt infection.
- The high prevalence of slime-producing S. epidermidis in aneurysmal grafts suggests a biofilm-mediated infection process.
- These findings highlight biofilm infection as a potential cause of late vascular graft complications.