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The Microbiology of Infective Native Aortic Aneurysms in a Population-Based Setting

Karl Sörelius1, Anders Wanhainen2, Mia Furebring3

  • 1Department of Vascular Surgery, Rigshospitalet, Copenhagen, and Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden.

Annals of Vascular Surgery
|September 19, 2021
PubMed
Abstract

Insights

Infective native aortic aneurysms (INAAs) are often caused by Staphylococcus aureus, Streptococcus, or Salmonella. High rates of infection-related complications (IRCs) following surgery suggest long-term antibiotics are necessary for INAA patients.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Microbiology

Background:

  • Infective native aortic aneurysms (INAAs) pose significant clinical challenges.
  • Understanding the causative pathogens and outcomes is crucial for effective management.

Purpose of the Study:

  • To describe the microbiology of surgically treated INAAs.
  • To analyze associated survival and infection-related complications (IRCs).

Main Methods:

  • Pooled data from two nationwide Swedish studies (1994-2016) of surgically treated INAA patients.
  • Patients were grouped by microbiological culture results (Staphylococcus aureus, Streptococcus sp., Salmonella sp., Enterococcus sp., Gram-negative intestinal bacteria, Other sp., Negative cultures).

Main Results:

  • 182 patients were included; 70.3% had positive cultures.
  • Staphylococcus aureus (20.9%), Streptococcus sp. (20.3%), and Salmonella sp. (10.4%) were the most common pathogens.
  • Two-year survival varied by pathogen, with Staphylococcus aureus and Enterococcus sp. showing lower survival rates.
  • 20.3% of patients developed IRCs, with 51.4% of these being fatal, primarily within the first postoperative year.

Conclusions:

  • Staphylococcus aureus, Streptococcus sp., and Salmonella sp. accounted for 50% of identified pathogens in INAAs.
  • The high frequency and mortality associated with IRCs underscore the need for prolonged antibiotic therapy, irrespective of initial culture findings.
Keywords:
bacteriainfection-related complicationsinfective native aortic aneurysmmicrobiologymycotic aortic aneurysm

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