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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.
Summary
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.
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.