The Role of Abdominal Drain Cultures in Managing Abdominal Infections

Area of Science:

• Infectious Diseases
• Surgical Infections
• Microbiology

Background:

• Intra-abdominal infections (IAI) are prevalent in hospitalized patients, requiring antimicrobial therapy and source control.
• While prophylactic drain use is declining, therapeutic drain use for IAI is increasing, leading to more drain sampling for antimicrobial guidance.

Purpose of the Study:

• To review the role of abdominal drains in surgery.
• To discuss biofilm formation in drains and its impact on diagnostic accuracy.
• To evaluate the clinical utility of sampling abdominal drains for diagnosing IAI.

Main Methods:

• Narrative review of current literature on abdominal drains in surgery.
• Examination of mechanisms of biofilm formation in drains.
• Analysis of clinical data regarding drain fluid sampling for IAI diagnosis.

Main Results:

• Biofilm formation and drain colonization are common in abdominal drains.
• Drain fluid sampling frequently fails to accurately diagnose IAI or identify causative pathogens.
• The presence of biofilm complicates the interpretation of microbiological results from drain fluid.

Conclusions:

• Biofilm formation in abdominal drains compromises their diagnostic reliability for IAI.
• Routine microbiological sampling of abdominal drains is not advised.
• Limiting drain use and avoiding routine sampling are recommended when drains are necessary.