Issn Print: 0265-0215

Publication Date: 2005/05/01


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Epidural analgesia: catheter contamination and secure time window: A-740

M. L. Paños; Y. Díez; A. González; M. De Miguel; O. Güénaga; V. A. Gancedo

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Background and Goal of Study: Epidural analgesia in surgical patients is not risk exempt. Epidural catheter (EC) tip colonization is up to 28.8% in some series (1) and may be associated with significant clinical infection (1) (2). The aim of this study was to evaluate the relationship between microbiological EC contamination and the duration of catheterization in surgical patients.
Materials and Methods: Bacteriological analysis of 104 triple EC cultures was carried out after removal in surgical patients: exit site swabs (CS), semiquantitative culture of 3cm of intra-dermis portion (IC) and 3cm of tip (TC). We recorded the duration of catheterization. Descriptive statistical analysis and Mantel-Haenszel Chi-Square tests were performed.
Results and Discussions: ECs were kept in place for 69 ± 34 hours (range 24-264). A significant correlation was found between the incidence of positive cultures and the duration of catheterization (CS p = 0.002, IC p = 0.027, TC p = 0.026). 64% of positive CS had also a positive IC and TC (decreasing number of colonies forming units from the skin to the tip). Coagulase-negative staphylococci (CNS) was the most prevalent microorganism cultured.
Conclusions: Contamination of the exit site by normal skin flora and subsequent spreading along the catheter track seems to be the most likely route of ECs colonization. The longer the catheterization, the higher the risk of ECs contamination gets. In surgical patients, ECs have to be removed when no longer needed for pain relief.
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