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[Factors related with microbiological contamination of surgical site in patients undergoing tracheotomy]
Alejandra Elizabeth Hernández-Durán1, Marcos Flavio Roque-Moreno1, José María de la Roca-Chiapas2
1Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No.1, Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello. León, Guanajuato, México.
Background:
Tracheotomy is a common technique; however, microbiological contamination of the surgical site can increase morbimortality. Up to 90% of patients present a positive culture of the airway. Among the most important related factors is the lack of tracheal cannula replacement and lower airway infections. It is convenient to identify microbiological contamination of surgical site in tracheal secretions samples and the specific microorganism associated.
Objective:
To determine the factors related to microbiological contamination of surgical site.
Material And Methods:
A prospective cohort study which included patients undergoing tracheotomy was carried out. Tracheal secretion was sampled by direct swabbing for culture during surgery and from the surgical site 5 days after.
Results:
The initial report showed contamination of samples in 58.3%, and 5 days after in 80.6%, with an incidence of contamination of 22.3%. Initially the main agents identified were Pseudomonas aeruginosa in 13.9% of the cultures, Klebsiella pneumoniae in 11.1% and Enterobacter spp. in 11%. On day 5, the most common agents were Klebsiella pneumoniae in 25% of the cases, Acinetobacter baumannii in 11.1% and Pseudomonas aeruginosa in 11.1.
Conclusions:
The frequency of microbiological contamination is high. The main agents were Staphylococcus aureus, Klebsiella pneumoniae and Pseudomonas aeruginosa. No risk factors for the presence of post-tracheotomy contamination were identified.
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