Culture-negative surgical site infections.
BACKGROUND
The appearance of postoperative surgical site infection (SSI) in the absence of culturable bacterial pathogens is a common dilemma for the surgeon.


METHODS
The literature was searched through references to primary articles, as well as a MEDLINE review, for reports of culture-negative SSIs.


RESULTS
Potential causes of culture-negative SSIs include prior antimicrobial therapy; the presence of fastidious or slow-growing microorganisms such as mycobacteria, Mycoplasma spp., and Legionella spp.; infection caused by mundane bacteria that may be dismissed as "contaminants"; factitious infection; and others.


CONCLUSIONS
We review the recognized causes of "culture negative" SSIs and discuss the laboratory capabilities that may enhance recognition of many of these pathogens and management options.
Rasnake
Mark S
MS
Infectious Disease Services, Wilford Hall Air Force Medical Center, Lackland AFB, Texas, USA. mark.rasnake@lackland.af.mil
Dooley
David P
DP
D003470:Culture Media; D006090:Gram-Negative Bacteria / Q000145:classification / Q000254:growth & development* / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000382:microbiology; D006094:Gram-Positive Bacteria / Q000145:classification / Q000254:growth & development* / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology; D013530:Surgical Wound Infection / Q000382:microbiology*
D003470:Culture Media