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Microbial Examination of Kidney Lithotripter Tub Water and Epidural Anesthesia Catheters

Published online by Cambridge University Press:  02 January 2015

Glenn L. Cooper ,
James T. Roberts ,
Amapola O'Brien ,
Marie Kelleher ,
Stephen P. Dretler ,
George E. Battit  and
Cyrus C. Hopkins
Glenn L. Cooper
Affiliation:
Infection Control Unit and Departments of Anesthesiology and Urology, Massachusetts General Hospital, Boston, Massachusetts
James T. Roberts
Affiliation:
Infection Control Unit and Departments of Anesthesiology and Urology, Massachusetts General Hospital, Boston, Massachusetts
Amapola O'Brien
Affiliation:
Infection Control Unit and Departments of Anesthesiology and Urology, Massachusetts General Hospital, Boston, Massachusetts
Marie Kelleher
Affiliation:
Infection Control Unit and Departments of Anesthesiology and Urology, Massachusetts General Hospital, Boston, Massachusetts
Stephen P. Dretler
Affiliation:
Infection Control Unit and Departments of Anesthesiology and Urology, Massachusetts General Hospital, Boston, Massachusetts
George E. Battit
Affiliation:
Infection Control Unit and Departments of Anesthesiology and Urology, Massachusetts General Hospital, Boston, Massachusetts
Cyrus C. Hopkins*
Affiliation:
Infection Control Unit and Departments of Anesthesiology and Urology, Massachusetts General Hospital, Boston, Massachusetts
*
Infection Control Unit, Massachusetts General Hospital, Fruit Street, Boston, MA 02114
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Abstract

Kidney lithotripsy patients frequently receive epidural anesthesia via indwelling epidural catheters. In our hospital, patients are immersed in a tub of warm, continuously-flowing tap water. The epidural catheter-entry site is covered by a transparent occlusive dressing. To determine the risk of microbial colonization of the epidural catheter during lithotripsy, we performed quantitative cultures of tub water and semiquantitative cultures of catheters in 63 lithotripsy procedures. Most of the tub water organisms were typical tap water and skin flora isolates. Total colony counts were generally low with no significant progression during the course of serial procedures. Forty-two epidural catheters were cultured; 34 (81%) were sterile, 8 (19%) were colonized with small numbers of flavobacteria or coagulase-negative staphylococci. Only four catheters had organisms present on catheter segments covered by the transparent occlusive dressing (in each case there was a single colony forming unit per semiquantitative plate) and these organisms were probable contaminants. We conclude that with our current lithotripsy procedures, the risk for the development of epidural catheter-associated infection seems to be low.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 7 , Issue 4 , April 1986 , pp. 216 - 219
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1986

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References

1.Chaussy, C, Schmiedt, E, Jocham, D: Nonsurgical treatment of renal calculi with shock waves, in Ruth, R, Finlayson, B (eds): Stones: Clinical Management of Urolithiasis. Baltimore, Williams and Wilkins, 1982, pp 461–476.Google Scholar
2.Chaussy, C, Schmiedt, E: Shock wave treatment for stones in the upper urinary tract. Urol Clin North Am 1983;10:743–750.Google Scholar
3.Finlayson, B, Thomas, WC Jr: Extracorporeal shock-wave lithotripsy. Ann Intern Med 1984;101:387–389.Google Scholar
4.Maki, DG, Weise, CE, Sarafin, HW: A semiquantitative culture method for identifying intravenous-catheter-associated infection. N Engl J Med 1977;296:1305–1309.Google Scholar
5.Christensen, GD, Simpson, WA, Beachey, EH: Microbial adherence in infection, in Mandel, GL, Douglas, RG, Bennett, JE (eds): Principles and Practice of Infectious Diseases. New York, John Wiley and Sons, 1985; pp 6–23.Google Scholar
6.Ludwicka, A, Jansen, B, Wadstrom, T, et al: Attachment of staphylococci to various synthetic polymers. Zentralb Bakteriol Mikrobiol Hyg 1984;250:479–489.Google Scholar
7.Sheth, NK, Rose, HD, Franson, TR, et al: In vitro adherence of bacteria to intravascular catheters. J Surg Res 1983;34:213–218.Google Scholar
8.North, JB, Brophy, BP: Epidural abscess: A hazard of spinal epidural anesthesia. Aust N Z J Surg 1979;49:484–485.Google Scholar
9.Wenningsted-Torgard, K, Heyn, J, Williamsen, L: Spondylitis following epidural morphine—a case report. Acta Anesthesiol Scand 1982;26:649–651.CrossRefGoogle Scholar
10.National Research Council. Drinking Water and Health. Washington, D.C., 1977;63–134.Google Scholar