Microbiological monitoring of aortic aneurysm sac contents during abdominal aneurysmectomy: results in 176 patients and review of the literature.

To investigate the clinical significance of intraoperative cultures, aneurysmal thrombus was cultured in 176 patients with clinically non suspected infected abdominal aortic aneurysm. The incidence of positive cultures was 14.2% and 88% of the microorganisms were Gram-positive. Differences between elective and urgent reconstruction were not significant. During follow-up, there were no cases of graft infection in either group. Review of the literature shows a positive culture rate of 19% in a series of 1867 patients. 93% Of the microorganisms are Gram-positive and 78% are considered as contaminants. The incidence of graft infection is 1.99% in the group with positive culture and 0.7% in the series with negative culture (P = 0.06). It is concluded that the clinical significance of routine cultures in clinically non suspected infected aortic aneurysms is negligible.