[Contribution of systematic culture of drainage fluids in Altemeier class 1 and 2 procedures].
OBJECTIVE
We conducted a prospective study to determine the therapeutic impact of systematic culture of suction drainage collections in Altemeier class I and II procedures.


METHODS
We examined the following questions: how many microbiologically positive samples and infections of the operative site were present in the included patients? for positive cases, what was the antibiotic prescription (excluding antibiotic prophylaxy protocols planned before surgery for cleaning)? if the sample was positive in a patient with no clinical infection, what antibiotics were prescribed?


RESULTS
A total of 1039 samples were collected in 470 patients undergoing Altemeier class I and II procedures. One hundred five cultures were positive in 34 patients who had undergone major surgery. There were 11 postoperative infections during the study period. Mean delay to diagnosis of infection was 19.5 days. Only one infected patient with positive drainage samples developed an infection on the 7(th) day; the causal germ was different from that identified in the drainage collection. Only one of the patients with a positive drainage sample was given antibiotics, but this treatment was initiated at peroperative reception of the laboratory results.


CONCLUSIONS
Our findings demonstrate that systematic samples of drainage collections make no contribution to therapeutic decision making in patients undergoing class I and II surgery.
Cosseron
M
M
Département de Microbiologie, Hôpital Universitaire de Bicêtre, 78, avenue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France.
Boisrenoult
P
P
Court
C
C
Gagey
O
O
Nordin
J Y
JY
Nordmann
P
P
D001419:Bacteria / Q000254:growth & development; D001424:Bacterial Infections / Q000382:microbiology*; D006801:Humans; D011183:Postoperative Complications / Q000382:microbiology*; D011446:Prospective Studies; D013396:Suction