Clinical implication of routine bacterial culture from epidural catheter tips in postoperative cancer patients: a prospective study.

We conducted a prospective study to determine the epidural tip culture pattern and its clinical implication in postoperative cancer patients. All patients scheduled to undergo various cancer surgeries requiring epidural analgesia were included. Epidural catheter tips were sent for culture on removal. Of the 466 epidural catheter tips sent for culture, 27 showed a positive culture (5.7%). The commonest organism identified was Staphylococcus aureus. There were no signs of local or epidural space infection in any of the patients. The rates of epidural catheter tip cultures in cancer patients are comparable to those in the general patients and the presence of a positive tip culture is not a predictor of epidural space infection. Hence, we recommend that even in cancer patients, routine culture of epidural catheters is not advisable, provided strict asepsis is maintained at the time of insertion, and patients are constantly monitored for early signs of epidural infection.