Drain Tip Culture Research Articles

Suction Drain Tip Culture after Spine Surgery: Can It Predict a Surgical Site Infection?

Study DesignRetrospective clinical study.PurposeTo assess the diagnostic value of suction drain tip culture in patients undergoing primary posterior spine surgery.Overview of LiteratureTo date, the diagnostic value of suction drain tip culture for predicting surgical site infection (SSI) has not been firmly established in orthopedic or spinal surgery.MethodsIn total, 133 patients who underwent primary posterior spine surgery from January 2013 to April 2015 were included in this retrospective study. Patients diagnosed with infective disease or condition was excluded. The suction drain tip was cut off approximately 5 cm from its far end. The sample was sent to the microbiological laboratory of the hospital for culture analysis. Any signs of infection, such as wound discharge or dehiscence, fever, chills, or chronic pain, were recorded. The culture outcome, identification of bacteria, and postoperative transition of the serum C-reactive protein level were also recorded in all patients. The wounds were followed up for a minimum of 3 months.ResultsA positive drain tip culture was found in 48 patients (36.1%), of whom, 6 developed SSI. The sensitivity of drain tip culture for SSI after primary posterior spine surgery was 60.0%, and the specificity was 65.9%. The association between the incidence of positive suction tip culture and SSI was not statistically significant. Among the 48 positive drain tip cultures, there was no significant association between the occurrence of SSI and virulence of isolated bacteria. There was no significant association between drain tip culture positivity and the duration of drainage, or between the rate of SSI and duration of drainage.ConclusionsSuction drain tip culture analysis is a poor predictor of SSI after primary posterior spine surgery. Routine use of a drain tip culture is not supported by the results of this study.

Drain tip cultures do not predict infections in primary total knee arthroplasty.

The possibility to predict surgical site infections development could be of high prognostic value. We aimed to investigate whether cultures obtained from the tip of the closed passive wound drain may provide early signs of progression towards periprosthetic joint infections. We performed an observational study on consecutive primary total knee arthroplasties performed in our department over 4 years by two high volume surgeons (it means they do a lot of arthroplasties/year; it is orthopedics specific). A total of 284 knees in 257 patients were included. Follow up was available for an average of 18.7 months. There were no simultaneous procedures. Nineteen (6.69%) drain tips yielded positive cultures, for a mean duration, from surgery to sample collection, of 1.63 (0.5) days. None of the positive drain tip cultures developed clinical signs of infection and all knees were healed at discharge after a mean of 13.78 days (SD= 3.34; range= 8-18). None of the 7 (2.46%) cases who developed deep infections had positive drain tip cultures. A true positive value of 0 led to a positive predictive value of 0, a negative predictive value of 97.34%, sensitivity of 0% and specificity of 93.14. The diagnostic use of passive drain tip cultures to detect early infections after total knee replacement is therefore absolutely useless.

The relationship among the duration of mediastinal drain insertion, contamination of drain tip culture and the incidence of surgical site infection after open heart surgery

The relationship among the duration of mediastinal drain insertion, contamination of drain tip culture and the incidence of surgical site infection after open heart surgery

Prognostic value of suction drain tip culture in determining joint infection in primary and non-infected revision total hip arthroplasty: a prospective comparative study and review of the literature

Closed suction drainage in joint replacement surgery has been considered to carry an obvious risk of bacteria invasion. Previous studies have shown controversial results regarding the role of suction drain culture in predicting artificial joint infection. Furthermore, the efficacy of the method has not been established in revision total hip or knee arthroplasty. Suction drain tips from 110 patients who underwent 73 primary and 37 revision non-infected total hip arthroplasties were prospectively cultured. The drains removed at 48 h postoperatively. The patients had an average age of 64.3 years (range 25-81 years) and followed up for 2-4 years (average 2.8 years). Positive cultures were identified in two primary (2.74%) and six revision (16.22%) total hip replacements (p = 0.017). The most frequently isolated microorganisms were Staphylococcus aureus (3 cases) and S. epidermidis (2 cases). Resistance to perioperative antibiotics was found in three out of eight isolated pathogens. However, no infection was recorded in any of the eight patients whose cultures found positive. Although suction drains are more often contaminated in revision total hip arthroplasty, the prognostic value of the method in determining joint infection is very limited and its routine use is not supported from the clinical data.

Diagnostic value of routine drain tip culture in primary joint arthroplasty

Closed suction drainage after joint arthroplasty is common practice in many institutions. The purpose of this study was to determine the correlation between routine drain tip culture and the diagnosis of superficial or deep postoperative wound infection after primary knee and hip replacement. Over a 12-month period, drain tips were retrieved and cultured in all patients who underwent unilateral primary total knee or hip replacement with the use of closed suction drainage. A total of 393 cultures was performed in 387 patients (145 hip replacements, 242 knee replacements). Patients were followed for an average of 8.9 months after surgery to assess for postoperative wound infection. Three patients had a positive drain tip culture, none of which were diagnosed with superficial or deep infection. Four patients (1%) were diagnosed with deep infection, 16 (4.1%) with superficial infection. No patient with either superficial or deep infection had a positive drain tip culture after their index procedure. The sensitivity of routine drain tip culture for the diagnosis of postoperative infection in primary joint replacement was 0% and specificity was 99.2%. These data do not support the practice of routine drain tip culture after primary hip or knee replacement for the diagnosis of postoperative infection.

Suction drain tip culture in orthopaedic surgery: a prospective study of 214 clean operations.

We conducted a prospective cohort study in order to determine whether suction drain specimen cultures from orthopaedic surgery predicted an early wound infection. We included 218 consecutive clean orthopaedic operations requiring drains in one unit over a period of 1 year. The suction drain tip, drain fluid and wound discharge specimens were cultured, and the surgical wound was followed up for 3 months. There were six deep and two superficial wound infections. Wound infection was significantly related to positive suction tip culture but not to positive drain fluid culture. Following our methodology for culture, a positive drain tip culture predicts wound infection in 50% and a negative culture virtually excludes the possibility of a deep infection.

Bacterial growth on suction drain tips: Prospective study of 489 clean orthopedic operations

The study included 489 clean orthopedic operations with implantation of major foreign materials (joint replacements and internal fixations of fractures). Specimens for culture were taken from the suction drainage system, either from the drain fluid or from the drain-tube tip or from both. Six superficial and five deep infections were seen following the operations. Only two cultures of drain fluid were positive, and neither of these became infected. Positive drain-tip cultures were seen after 56 operations, and of these, five were followed by infection. The risk of infection was increased if Staphylococcus aureus, Enterobacteriaceae, or Streptococcus faecalis was cultured from drain tips. Drain-tip cultures growing only coagulase-negative staphylococci, nonhemolytic streptococci, and corynebacteria were not correlated with increased risk of infection. There was a not significant tendency towards fewer infections if positive drain-tip cultures with virulent bacteria were treated with specific antibiotics.