Long-term Follow-up of Positive Cultures in 500 Abdominal Aortic Aneurysms

Jean-Christophe Farkas, MD; Jean-Marc Fichelle, MD; Claude Laurian, MD; Alain Jean-Baptiste, MD; Frederic Gigou, MD; Jean Marzelle, MD; Fred W. Goldstein, MD; Jean-Michel Cormier, MD
Arch Surg. 1993;128(3):284-288. doi:10.1001/archsurg.1993.01420150038007.
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• Routine aneurysm culture is frequently performed as it is thought that a positive culture could be a risk factor for secondary graft infection. Five hundred aneurysms, in a series of 796 patients, had microbiologic examination of the thrombus and/or aneurysm wall. Cultures were positive in 185 cases (37%), mostly due to normal skin flora microorganisms (80%), whereas 16 patients (3.2%) had infectious aortitis. Gram-stained smears were positive in nine of these 16 patients compared with two of the other 169. Of the 185 patients with positive culture, after a mean length of followup of 35 months, only one had a graft infection that occurred 6 years later and was not due to the same microorganism. Graft sepsis was diagnosed in six of the 296 patients who did not have a positive culture, and was related to clinically obvious locoregional or systemic foci. In this series, positive cultures from aneurysm without rupture or signs of infection were not a risk factor for secondary graft sepsis. Therefore, in cases of asymptomatic unruptured aneurysm, routine culturing is not necessary as a positive result has no pathogenic significance or therapeutic implication.

(Arch Surg. 1993;128:284-288)


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