Bacterial Colony Counts During Vaginal Surgery

Author:

Culligan Patrick1,Heit Michael1,Blackwell Linda1,Murphy Miles1,Graham Carol A.1,Snyder James2

Affiliation:

1. Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics, Gynecology and Women’s Health, 315 East Broadway M-18, Louisville, KY 40202, USA

2. Division of Laboratory Medicine, Department of Pathology, University of Louisville Health Sciences Center, Louisville, KY, USA

Abstract

Objective:To describe the bacterial types and colony counts present before and during vaginal surgery.Methods:A descriptive study was undertaken of patients undergoing vaginal hysterectomy with or without reconstructive pelvic surgery. Aerobic and anaerobic bacterial cultures were obtained immediately before and throughout the surgical cases at preselected time intervals. Standard antimicrobial prophylaxis was administered in all cases. Mean total colony counts and mean anaerobic colony counts were determined by adding all colonies regardless of bacteria type. ‘Contamination’ was defined as ≥ 5000 colony-forming units/ml.Results:A total of 31 patients aged 26 to 82 years (mean age ± SD, 51 ± 15) were included. The highest total and anaerobic colony counts were found at the first intraoperative time interval. On the first set of cultures (30 minutes after the surgical scrub), 52% (16/31) of the surgical fields were contaminated, and at 90 minutes, 41% (12/29) were contaminated. A negligible number of subsequent cultures were contaminated.Conclusions:Any future interventions designed to minimize bacterial colony counts should focus on the first 30 to 90 minutes of surgery.

Funder

American College of Obstetricians and Gynecologists

Publisher

Hindawi Limited

Subject

Infectious Diseases,Obstetrics and Gynecology,Dermatology

Reference8 articles.

1. Hemsell, D.(2000) Gynecologic postoperative infections and antimicrobial prophylaxis. In Principles and Practice of Infectious Diseases5th. ( pp. 3177 - 91 ). Philadelphia PA: Churchill Livingstone.

2. Bolling, D and Plunkett, G. (1973) Prophylactic antibiotics for vaginal hysterectomies Obstet Gynecol, 41, pp. 689 - 92.

3. Tanos, V and Rojansky, N. (1994) Prophylactic antibiotics in abdominal hysterectomy J Am Coll Surg, 179, pp. 593 - 600.

4. Mittendorf, R and Aronson, M and Berry, R and (1993) Avoiding serious infections associated with abdominal hysterectomy: a meta-analysis of antibiotic prophylaxis Am J Obstet Gynecol, 169, pp. 1119 - 24.

5. American College of Obstetricians and Gynecologists.(2001) Antibiotic Prophylaxis for Gynecologic Procedures. American College of Obstetricians and Gynecologists.

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