Bacterial contamination of epidural needles and catheters

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summaryBackgroundWe estimated the possibility of bacterial contamination of the epidural space during catheterization. We prospectively investigated the incidence of bacterial contamination of the tips of epidural needles and indwelling epidural catheters, and also of disinfected skin at puncture sites.MethodsOne hundred pain clinic patients received a total of 110 continuous epidural blocks. After local preparation with 0.5% chlorhexidine ethanol, the skin was swabbed with a small piece of saline-soaked cotton gauze for bacterial examination of the puncture site. The epidural space was punctured with an 18-G Tuohy needle, followed by placement of an epidural catheter. The tip of the needle was cut immediately after removal and incubated for bacterial examination. The tip of the indwelling catheter was also cut and incubated after removal. Bacteria in all samples were examined at the clinical laboratory in our institute.ResultsThe incidence of bacteriological contamination was as follows: 9 (8.2%) in the gauze samples, 21 (19.1%) in the needle-tips and 14 (12.7%) in the catheter tips. The most frequently detected type of bacteria from the epidural needle and catheters tips was staphylococcus.ConclusionsBacterial contamination could not be completely avoided during epidural space puncturing and indwelling catheterization, despite aseptic techniques. Contamination of the epidural needle could be one cause of epidural infection.

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