Microbial spectrum and primary resistance to rifampicin in infectious complications in vascular surgery: limits to the use of rifampicin-bonded prosthetic grafts.

There are reports that rifampicin-bonded prosthetic grafts might be a suitable alternative to autologous grafts in vascular graft infections and infectious vascular complications. We characterize the spectrum of microbial agents and susceptibility to antibiotic treatment, especially to rifampicin, in these patients. We carried out a retrospective analysis of wound-swaps and blood cultures in 48 patients with infected prosthetic vascular grafts or primary infectious vascular complications. In 15 of 48 patients (31%), the analysis showed that the microbial organism causing the infection was resistant or not susceptible to rifampicin. Rifampicin-bonded prosthetic grafts should be used with caution in acute infectious complications in vascular surgery, because in about 30% of the cases, the initiating microbial organisms are resistant or not susceptible to rifampicin. Without preoperative confirmation of susceptibility to rifampicin, autologous reconstruction should be preferred.