title: Bacterial colonization after tunneling in 402 perineural catheters: a prospective study.
abstract: BACKGROUND
  Bacterial colonization of peripheral nerve catheters is frequent, although infection is relatively rare. With central venous catheters, the tunneling of the catheter into the subcutaneous tissue significantly decreases catheter colonization and catheter-related sepsis. We evaluated the incidence of bacterial colonization in adult patients with tunnelized perineural nerve catheters.
  
  
  METHODS
  Peripheral nerve catheters placed under sterile conditions for postoperative analgesia were evaluated prospectively. After removal, they were analyzed for colonization. Quantitative culture was used as described by Brun-Buisson for intravascular catheters. The site of insertion was monitored daily for any signs of infection.
  
  
  RESULTS
  Four-hundred-two patients were included in the study during a 2-yr period. The mean duration of peripheral nerve catheters was 48 h (47-50.4). Positive culture occurred in 25 catheters, indicating that the incidence of colonization was 6.22% (3.8-8.5). The microbiological analysis of the catheter tip cultures revealed coagulase-negative staphylococci in 72%. Twenty-two catheters of 25 catheters each had one microorganism, and for three catheters, two microorganisms were identified. No infection was found in any patient.
  
  
  CONCLUSIONS
  The incidence of perineural catheter colonization is low with subcutaneous tunneling. Controlled randomized studies are warranted to determine whether this procedure decreases the risk for infection.
authors.affiliation: Department of Anesthesia and Intensive Care, Rouen University Hospital, 1 rue de Germont, 76031 Rouen, France. vincent.compere@chu-rouen.fr
authors.forename: Vincent
authors.initials: V
authors.lastname: Compère
authors.forename: J F
authors.initials: JF
authors.lastname: Legrand
authors.forename: P G
authors.initials: PG
authors.lastname: Guitard
authors.forename: K
authors.initials: K
authors.lastname: Azougagh
authors.forename: O
authors.initials: O
authors.lastname: Baert
authors.forename: A
authors.initials: A
authors.lastname: Ouennich
authors.forename: V
authors.initials: V
authors.lastname: Fourdrinier
authors.forename: N
authors.initials: N
authors.lastname: Frebourg
authors.forename: B
authors.initials: B
authors.lastname: Dureuil
mesh_terms: D000368:Aged; D000698:Analgesia / Q000295:instrumentation*; D055499:Catheter-Related Infections / Q000382:microbiology* / Q000517:prevention & control; D002404:Catheterization / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000382:microbiology*; D015169:Colony Count, Microbial; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D010525:Peripheral Nerves; D011446:Prospective Studies; D013210:Staphylococcus / Q000302:isolation & purification*; D013997:Time Factors