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Infectious complications associated with temporary epidural catheters

D A Pegues1, D B Carr, C C Hopkins

  • 1Department of Medicine, Massachusetts General Hospital, Boston 02114.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|November 1, 1994
PubMed
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Temporary epidural catheters can cause deep-tissue or local infections, including abscesses and meningitis. Prompt removal and antimicrobial therapy are crucial for managing these serious epidural catheter infections.

Area of Science:

  • Infectious Diseases
  • Neurosurgery
  • Anesthesiology

Background:

  • Temporary epidural catheters are commonly used for pain management in hospitalized patients.
  • Infections associated with epidural catheters can lead to significant morbidity.

Purpose of the Study:

  • To identify and characterize infections linked to temporary epidural catheters.
  • To determine the types and outcomes of epidural catheter-associated infections.

Main Methods:

  • Retrospective review of medical records (1980-1992) and prospective follow-up (1993).
  • Inclusion criteria: patients hospitalized at a tertiary referral hospital with temporary epidural catheters.
  • Data collection focused on identifying deep-tissue and local infections.

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Main Results:

  • Seven cases of epidural catheter-associated infection were identified.
  • Infections included three deep-tissue (paraspinal abscess, epidural abscess, meningitis) and four local infections.
  • Staphylococcus aureus was the most common pathogen (57%); infections occurred 2-22 days post-insertion.

Conclusions:

  • Daily inspection and prompt removal of epidural catheters are vital if infection is suspected.
  • Treatment involves catheter removal, antimicrobial therapy, and potentially surgical drainage for deep-tissue infections.
  • These findings highlight the risks and management of epidural catheter infections.