Microbiology of explanted suture segments from infected and noninfected surgical patients. J Clin Microbiol 2013 Feb;51(2):417-21
Date
11/24/2012Pubmed ID
23175247Pubmed Central ID
PMC3553868DOI
10.1128/JCM.02442-12Scopus ID
2-s2.0-84873052373 (requires institutional sign-in at Scopus site) 56 CitationsAbstract
Sutures under selective host/environmental factors can potentiate postoperative surgical site infection (SSI). The present investigation characterized microbial recovery and biofilm formation from explanted absorbable (AB) and nonabsorbable (NAB) sutures from infected and noninfected sites. AB and NAB sutures were harvested from noninfected (70.9%) and infected (29.1%) sites in 158 patients. At explantation, devices were sonicated and processed for qualitative/quantitative bacteriology; selective sutures were processed for scanning electron microscopy (SEM). Bacteria were recovered from 85 (53.8%) explanted sites; 39 sites were noninfected, and 46 were infected. Suture recovery ranged from 11.1 to 574.6 days postinsertion. A significant difference in mean microbial recovery between noninfected (1.2 isolates) and infected (2.7 isolates) devices (P < 0.05) was noted. Staphylococcus epidermidis, Staphylococcus aureus, coagulase-negative staphylococci (CNS), Peptostreptococcus spp., Bacteroides fragilis, Escherichia coli, Enterococcus spp., Pseudomonas aeruginosa, and Serratia spp. were recovered from infected devices, while commensal skin flora was recovered from noninfected devices. No significant difference in quantitative microbial recovery between infected monofilament and multifilament sutures was noted. Biofilm was present in 100% and 66.6% of infected and noninfected devices, respectively (P < 0.042). We conclude that both monofilament and braided sutures provide a hospitable surface for microbial adherence: (i) a significant difference in microbial recovery from infected and noninfected sutures was noted, (ii) infected sutures harbored a mixed flora, including multidrug-resistant health care-associated pathogens, and (iii) a significant difference in the presence or absence of a biofilm in infected versus noninfected explanted devices was noted. Further studies to document the benefit of focused risk reduction strategies to minimize suture contamination and biofilm formation postimplantation are warranted.
Author List
Edmiston CE Jr, Krepel CJ, Marks RM, Rossi PJ, Sanger J, Goldblatt M, Graham MB, Rothenburger S, Collier J, Seabrook GRAuthors
Matthew I. Goldblatt MD Professor in the Surgery department at Medical College of WisconsinMary Beth Graham MD Associate Chief, Professor in the Medicine department at Medical College of Wisconsin
Peter J. Rossi MD Chief, Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Bacteria, AerobicBacteria, Anaerobic
Bacterial Infections
Biofilms
Humans
Postoperative Complications
Sutures