Barbara Kokosar Ulcar1, Nikola Lakic2, Samo Jeverica3, Blaz Pecavar1, Mateja Logar1, Tjasa Kisek Cerar3, Tatjana Lejko-Zupanc1. 1. a Department of Infectious Diseases and Febrile Illnesses , University Medical Centre Ljubljana , Ljubljana , Slovenia. 2. b Department of Cardiovascular Surgery , University Medical Centre Ljubljana , Ljubljana , Slovenia. 3. c Faculty of Medicine, Institute of Microbiology and Immunology , University of Ljubljana , Ljubljana , Slovenia.
Abstract
BACKGROUND: Vascular graft infections (VGI) are associated with considerable morbidity and mortality, and antimicrobial treatment is an important adjunct to surgical treatment. While microbial aetiology of VGI is often difficult to determine, other techniques such as sonication of implanted material may be used to enhance the recovery of biofilm-associated organisms. METHODS: We performed a retrospective analysis of 22 consecutive patients treated for VGI at University Medical Centre Ljubljana from May 2011 through January 2015. Explanted vascular grafts were flooded with sterile Ringer solution, sonicated for 1 min at a frequency of 40 kHz and inoculated on solid and liquid culture media. Aerobic and anaerobic cultures were performed, incubated for 14 days and any significant bacterial growth was quantitatively evaluated. Additionally, broad-range PCR from sonicate fluid was performed. Microbiological results were compared with the results of preoperatively taken blood cultures and the results of intraoperative tissue cultures (material from peri-graft collection). RESULTS: Identification of the causative organism (irrespective of the method) was achieved in 95.8%. Preoperative blood cultures were positive in 35.3%, intraoperative tissue cultures in 31.8%, sonicate fluid culture in 79.2%, while broad-range PCR from sonicate fluid was positive in 66.7%. In 37.5% the pathogen detected in sonicate fluid culture or broad-range PCR was the only positive microbiological result. CONCLUSIONS: Sonicate fluid culture and broad-range PCR from explanted vascular grafts may contribute to optimization of antimicrobial treatment. Optimal timing of antibiotic therapy before explantation should be further assessed to improve diagnostic yield.
BACKGROUND:Vascular graft infections (VGI) are associated with considerable morbidity and mortality, and antimicrobial treatment is an important adjunct to surgical treatment. While microbial aetiology of VGI is often difficult to determine, other techniques such as sonication of implanted material may be used to enhance the recovery of biofilm-associated organisms. METHODS: We performed a retrospective analysis of 22 consecutive patients treated for VGI at University Medical Centre Ljubljana from May 2011 through January 2015. Explanted vascular grafts were flooded with sterile Ringer solution, sonicated for 1 min at a frequency of 40 kHz and inoculated on solid and liquid culture media. Aerobic and anaerobic cultures were performed, incubated for 14 days and any significant bacterial growth was quantitatively evaluated. Additionally, broad-range PCR from sonicate fluid was performed. Microbiological results were compared with the results of preoperatively taken blood cultures and the results of intraoperative tissue cultures (material from peri-graft collection). RESULTS: Identification of the causative organism (irrespective of the method) was achieved in 95.8%. Preoperative blood cultures were positive in 35.3%, intraoperative tissue cultures in 31.8%, sonicate fluid culture in 79.2%, while broad-range PCR from sonicate fluid was positive in 66.7%. In 37.5% the pathogen detected in sonicate fluid culture or broad-range PCR was the only positive microbiological result. CONCLUSIONS: Sonicate fluid culture and broad-range PCR from explanted vascular grafts may contribute to optimization of antimicrobial treatment. Optimal timing of antibiotic therapy before explantation should be further assessed to improve diagnostic yield.
Authors: Evelyne Ajdler-Schaeffler; Alexandra U Scherrer; Peter M Keller; Alexia Anagnostopoulos; Michael Hofmann; Zoran Rancic; Annelies S Zinkernagel; Guido V Bloemberg; Barbara K Hasse Journal: Front Med (Lausanne) Date: 2018-06-04
Authors: Alessandra Oliva; Maria Claudia Miele; Dania Al Ismail; Federica Di Timoteo; Massimiliano De Angelis; Luigi Rosa; Antimo Cutone; Mario Venditti; Maria Teresa Mascellino; Piera Valenti; Claudio Maria Mastroianni Journal: Front Microbiol Date: 2021-10-29 Impact factor: 5.640