title: Bacterial contamination of epidural catheters: microbiological examination of 502 epidural catheters used for postoperative analgesia.
abstract: OBJECTIVE
  To investigate the frequency of bacterial colonization of epidural catheters used for postoperative pain treatment longer than 24 hours in abdominal, thoracic, or trauma surgery patients.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Intermediate care facility and general ward of a university hospital.
  
  
  METHODS
  502 patients who received epidural catheters after abdominal, thoracic, or vascular surgery at our institution from January 1996 to December 2000.
  
  
  METHODS
  Placement of an epidural catheter, which was used for postoperative pain treatment, for more than 24 hours. The puncture site dressing included saturation each day with povidone-iodine.
  
  
  RESULTS
  Microbiologic monitoring of epidural catheter tips and daily examination of puncture sites with regard to signs of inflammation took place. Four times daily patients were examined to check adequacy of pain treatment and neurologic deficits. Catheter tip cultures were positive in 29 patients (5.8%). Staphylococcus epidermidis was isolated in 22 cases (76%). No case of spinal epidural abscess was observed within 6 months after epidural catheterization. The average catheterization time was 5 days (quartile range: 4 to 6 days).
  
  
  CONCLUSIONS
  Meticulous management ensures a relatively low level of bacterial contamination in epidural catheters applied for postoperative pain treatment greater than 5 days. Contamination rarely leads to spinal epidural infection.
authors.affiliation: Department of Anesthesiology, University of Ulm, Ulm, Germany. peter.steffen@medizin.uni-ulm.de
authors.forename: Peter
authors.initials: P
authors.lastname: Steffen
authors.forename: Wulf
authors.initials: W
authors.lastname: Seeling
authors.forename: Andreas
authors.initials: A
authors.lastname: Essig
authors.forename: Erika
authors.initials: E
authors.lastname: Stiepan
authors.forename: Michael Georg
authors.initials: MG
authors.lastname: Rockemann
mesh_terms: D000368:Aged; D015360:Analgesia, Epidural / Q000295:instrumentation*; D001419:Bacteria / Q000302:isolation & purification*; D002404:Catheterization; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000628:therapy*; D013210:Staphylococcus / Q000302:isolation & purification; D013291:Streptococcus / Q000302:isolation & purification