Successful Treatment with Percutaneous Catheter Drainage and Irrigation for Methycillin-Resistant Staphylococcus aureus Graft Infection Following Abdominal Aneurysm Repair

We report 2 cases of successful treatment by percutaneous catheter drainage and irrigation for methycillin-resistant Staphylococcus aureus (MRSA) prosthetic graft infection after abdominal aortic aneurysm (AAA) repair. Case 1 was a 71-year-old man in whom MRSA graft infection was diagnosed on the ba...

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Published inJapanese Journal of Cardiovascular Surgery Vol. 32; no. 6; pp. 347 - 349
Main Authors Taniguchi, Kenichiro, Umesue, Masayoshi, Nakamura, Kenichi, Nagano, Ichiro, Fukumura, Fumio, Boku, Noriko, Ando, Hiromi, Tanaka, Jiro, Kimura, Satoshi
Format Journal Article
LanguageJapanese
Published The Japanese Society for Cardiovascular Surgery 2003
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ISSN0285-1474
1883-4108
DOI10.4326/jjcvs.32.347

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Abstract We report 2 cases of successful treatment by percutaneous catheter drainage and irrigation for methycillin-resistant Staphylococcus aureus (MRSA) prosthetic graft infection after abdominal aortic aneurysm (AAA) repair. Case 1 was a 71-year-old man in whom MRSA graft infection was diagnosed on the basis of high fever and CT-guided taps of the perigraft fluid 11 days after AAA repair, and a percutaneous catheter was inserted into the perigraft space by the CT-guided method. Case 2 was a 77-year-old man in whom MRSA graft infection was diagnosed because of high fever and purulent discharge from the wound of retroperitoneal drainage 5 days after AAA repair. A percutaneous catheter was placed into the retroperitoneal space via an extraperitoneal route. In both cases, intermittent irrigation by 0.5% Povidone-iodine solution and saline was performed as well as systemic and local antibiotic administration. The graft infection was well controlled and both patients were discharged after 4 months. Percutaneous catheter drainage and irrigation can be one of the choices for critically ill patients with graft infection after AAA repair.
AbstractList We report 2 cases of successful treatment by percutaneous catheter drainage and irrigation for methycillin-resistant Staphylococcus aureus (MRSA) prosthetic graft infection after abdominal aortic aneurysm (AAA) repair. Case 1 was a 71-year-old man in whom MRSA graft infection was diagnosed on the basis of high fever and CT-guided taps of the perigraft fluid 11 days after AAA repair, and a percutaneous catheter was inserted into the perigraft space by the CT-guided method. Case 2 was a 77-year-old man in whom MRSA graft infection was diagnosed because of high fever and purulent discharge from the wound of retroperitoneal drainage 5 days after AAA repair. A percutaneous catheter was placed into the retroperitoneal space via an extraperitoneal route. In both cases, intermittent irrigation by 0.5% Povidone-iodine solution and saline was performed as well as systemic and local antibiotic administration. The graft infection was well controlled and both patients were discharged after 4 months. Percutaneous catheter drainage and irrigation can be one of the choices for critically ill patients with graft infection after AAA repair.
Author Boku, Noriko
Kimura, Satoshi
Tanaka, Jiro
Umesue, Masayoshi
Ando, Hiromi
Fukumura, Fumio
Nakamura, Kenichi
Taniguchi, Kenichiro
Nagano, Ichiro
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References 5) Morris, G. E., Friend, P. J., Vassallo, D. J. et al.: Antibiotic irrigation and conservative surgery for major aortic graft infection. J. Vasc. Surg. 20: 88-95, 1994.
2) Seeger, J. M., Pretus, H. A., Welborn, B. et al.: Longterm outcome after treatment of aortic graft infection with staged extra-anatomic bypass grafting and aortic graft removal. J. Vasc. Surg. 32: 451-461, 2000.
7) 松田宙,榊原哲夫,阪越信雄ほか:持続洗浄ドレナージおよび抗生物質長期投与が奏効した破裂性腹部大動脈瘤術後の人工血管感染の1治験例.日心外会誌30:187-189,2001.
6) 川嶋隆久,上沢修,大木伸一ほか:持続ドレナージ療法及び抗生物質長期投与にて軽快した胸腹部大動脈瘤術後人工血管感染の1例.日胸外会誌45:220-224,1997.
3) Hayes, P. D., Nasim, A., London, N. J. M. et al.: In situ replacement of infected aortic grafts with rifampicinbonded prostheses. J. Vasc. Surg. 30: 92-98, 1999.
8) 佐藤藤夫,軸屋智昭,倉持正志ほか:腹部大動脈瘤術後に発生した人工血管感染症に対するCTガイド下穿刺の有用性.日血外会誌10:613-618,2001.
1) 大北裕:人工血管感染症に対する治療.Annual Review循環器2000,中外医学社,東京,2000,pp.262-267.
4) 矢野浩巳,石丸新,石川幹夫ほか:大網充填術が奏効した胸腹部大動脈瘤術後MRSA感染の1治癒例.日心外会誌27:380-382,1998.
References_xml – reference: 2) Seeger, J. M., Pretus, H. A., Welborn, B. et al.: Longterm outcome after treatment of aortic graft infection with staged extra-anatomic bypass grafting and aortic graft removal. J. Vasc. Surg. 32: 451-461, 2000.
– reference: 4) 矢野浩巳,石丸新,石川幹夫ほか:大網充填術が奏効した胸腹部大動脈瘤術後MRSA感染の1治癒例.日心外会誌27:380-382,1998.
– reference: 5) Morris, G. E., Friend, P. J., Vassallo, D. J. et al.: Antibiotic irrigation and conservative surgery for major aortic graft infection. J. Vasc. Surg. 20: 88-95, 1994.
– reference: 8) 佐藤藤夫,軸屋智昭,倉持正志ほか:腹部大動脈瘤術後に発生した人工血管感染症に対するCTガイド下穿刺の有用性.日血外会誌10:613-618,2001.
– reference: 1) 大北裕:人工血管感染症に対する治療.Annual Review循環器2000,中外医学社,東京,2000,pp.262-267.
– reference: 3) Hayes, P. D., Nasim, A., London, N. J. M. et al.: In situ replacement of infected aortic grafts with rifampicinbonded prostheses. J. Vasc. Surg. 30: 92-98, 1999.
– reference: 7) 松田宙,榊原哲夫,阪越信雄ほか:持続洗浄ドレナージおよび抗生物質長期投与が奏効した破裂性腹部大動脈瘤術後の人工血管感染の1治験例.日心外会誌30:187-189,2001.
– reference: 6) 川嶋隆久,上沢修,大木伸一ほか:持続ドレナージ療法及び抗生物質長期投与にて軽快した胸腹部大動脈瘤術後人工血管感染の1例.日胸外会誌45:220-224,1997.
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Snippet We report 2 cases of successful treatment by percutaneous catheter drainage and irrigation for methycillin-resistant Staphylococcus aureus (MRSA) prosthetic...
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Title Successful Treatment with Percutaneous Catheter Drainage and Irrigation for Methycillin-Resistant Staphylococcus aureus Graft Infection Following Abdominal Aneurysm Repair
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