Multiple fluid collections: CT- or US-guided aspiration--evaluation of microbiologic results and implications for clinical practice.

Published

Journal Article

PURPOSE: To determine if patients with multiple fluid collections need every collection aspirated and if cross-contamination is a risk if separate sterile procedures are not followed for each aspiration. MATERIALS AND METHODS: Records from 1,076 imaging-guided percutaneous aspirations and drainages over 39 months were retrospectively reviewed; 124 patients had multiple fluid collections drained, which yielded 287 aspirates. The patients were divided into two groups: those (n = 82) with multiple collections aspirated on any 1 day, and those (n = 61) with multiple collections aspirated over 10 days. Nineteen patients were included in both groups. Gram stain microscopy and culture results were compared between sequential aspirates in each patient, and their potential effects on antimicrobial therapy and theoretic risk for cross-contamination were evaluated. RESULTS: In 82 patients undergoing multiple aspirations on any 1 day, multiple microorganisms differed in 32 patients, which indicated a need for therapy change in 18 (22%) patients. In 61 patients undergoing aspiration on different days, microorganisms differed in 32 patients, which indicated a need for therapy change in 15 (25%) patients. Cross-contamination could have occurred in 28 of 93 (30%) aspirates from patients with a second or subsequent collection if separate sterile procedures had not been undertaken. CONCLUSION: When multiple fluid collections are identified, aspirates from all collections should be obtained through separate sterile procedures to ensure optimal antimicrobial coverage and avoid cross-contamination.

Full Text

Duke Authors

Cited Authors

  • Heneghan, JP; Everts, RJ; Nelson, RC

Published Date

  • September 1999

Published In

Volume / Issue

  • 212 / 3

Start / End Page

  • 669 - 672

PubMed ID

  • 10478230

Pubmed Central ID

  • 10478230

International Standard Serial Number (ISSN)

  • 0033-8419

Digital Object Identifier (DOI)

  • 10.1148/radiology.212.3.r99se25669

Language

  • eng

Conference Location

  • United States