Evaluation of blood cultures following laparoscopy

To determine the incidence of transient bacteremia associated with laparoscopy, a prospective study was carried out in 113 patients with diverse liver diseases. Blood samples for aerobic and anaerobic cultures were obtained for each patient immediately before laparoscopy, within three minutes after creation of pneumoperitoneum and within three minutes after needle biopsy of the liver. Five subjects were culture positive, and all isolates were of the propionibacterium species. Positive cultures did not correlate with the nature of underlying liver disease, and none of these patients developed clinical evidence of bacterial infection. Positive isolates might be assumed to be contaminants, but the fact propionibacterium has been known to cause endocarditis cannot be ignored. Until further evidence accumulates, antibiotic coverage in "high risk" patients with cardiac lesions who are predisposed to endocarditis undergoing laparoscopy may be warranted.