New bacteriological patterns in primary infected aorto-iliac aneurysms: a single-centre experience.
OBJECTIVE
To assess causative pathogens and surgical outcomes in patients with primary infected aorto-iliac aneurysms at our institution.


METHODS
Retrospective study of patients treated at a university hospital between 1992 and 2009.


RESULTS
We identified 26 patients (median age, 63 years) with primary infected aneurysms on the aorta (descending thoracic, n = 2; thoraco-abdominal, n = 3; suprarenal, n = 2; infrarenal, n = 15) or iliac arteries (n = 4). Among them, 22 were symptomatic, including 13 with ruptured aneurysms. The causative organisms, identified in 25/26 patients, were Campylobacter fetus, n = 6; Streptococcus pneumoniae, n = 4; Listeria, n = 3; Salmonella, n = 2; Mycobacterium tuberculosis, n = 2; Staphylococcus aureus, n = 1; and other, n = 7. Immune suppression was a feature in 10 (38.4%) patients. Revascularisation was performed in situ in 23 patients (10 allografts, eight grafts, three superficial femoral veins, and 2 stentgrafts) and by extra-anatomic bypass in three patients. Hospital mortality was 23% (in situ group, 17.4%; extra-anatomic group, 66.7%; χ(2)(Yates), P = 0.24). During follow-up in the 20 survivors (median, 48.5 months), there were two non-infection-related deaths (five and 24 months) and six (30%) vascular complications.


CONCLUSIONS
The bacteriological spectrum of primary infected aorto-iliac aneurysms was wider than previously reported. The availability of new diagnostic tests and increased prevalence of immunosuppression may explain this finding.
Brossier
J
J
Department of Vascular Surgery, Henri Mondor Hospital, AP/HP, University Paris Val de Marne, Créteil 94000, Paris, France.
Lesprit
P
P
Marzelle
J
J
Allaire
E
E
Becquemin
J-P
JP
Desgranges
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000785:Aneurysm, Infected / Q000382:microbiology* / Q000401:mortality / Q000601:surgery; D001014:Aortic Aneurysm / Q000382:microbiology* / Q000401:mortality / Q000601:surgery; D001019:Aortic Rupture / Q000382:microbiology* / Q000401:mortality / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D017543:Iliac Aneurysm / Q000382:microbiology* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult