| Autor: |
J R, Durham, J M, Malone, V M, Bernhard |
| Rok vydání: |
1987 |
| Předmět: |
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| Zdroj: |
Journal of Vascular Surgery. 5:160-169 |
| ISSN: |
0741-5214 |
| DOI: |
10.1067/mva.1987.avs0050160 |
| Popis: |
The present study reviewed arterial culture data from 172 patients undergoing major vascular reconstructions between July 1, 1977, and Dec. 31, 1984. Prosthetic graft infection was documented in 0 of 97 cases (0%) with negative arterial cultures but in six of 75 cases (8%) with positive arterial cultures (chi 2 = 5.84; 0.01 less than p less than 0.025). The data were reanalyzed after the patients were subdivided into two groups on the basis of the numbers of operations: group I (132 patients)--a culture obtained at initial vascular reconstruction--and group II (40 patients)--a culture obtained at a subsequent vascular reconstruction. Positive arterial cultures had no predictive value for graft infection among patients in group I (1 of 57 cases vs. 0 of 75 cases; chi 2 = 0.019), whereas the presence of positive arterial cultures was associated with a significant increase in the incidence of graft infection in group II patients (5 of 18 cases vs. 0 of 22 cases; chi 2 = 4.68; 0.025 less than p less than 0.05). For group I patients, we believe that neither routine arterial culture nor long-term antibiotic therapy for patients with positive arterial cultures is indicated. For group II patients we recommend that routine arterial cultures should be obtained; perioperative antibiotics should be continued until definitive arterial culture information is available; and positive arterial cultures should be treated with a short course of high-dose intravenous antibiotics. Thereafter, long-term treatment of positive arterial cultures with oral antibiotics, although not statistically validated, is probably appropriate. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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