The relevance of the microbiological flora of the upper alimentary tract to postoperative infection in major oesophageal surgery

• Published in: European journal of cardio-thoracic surgery Vol. 6; no. 8; pp. 403 - 405
• Main Authors: SHARPE, D. A. C, CHERVENIAKOV, A, RENWICK, P, MOGHISSI, K
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Science B.V 1992; Elsevier Science
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Esophagus; Esophagus - microbiology; Esophagus - surgery; Female; Humans; Male; Medical sciences; Middle Aged; Postoperative Care; Postoperative Complications - microbiology; Preoperative Care; Sputum - microbiology; Stomach - microbiology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Infection; Human; Microbiological investigation; Treatment; Respiratory disease; Pathogenesis; Surgery; Lung; Digestive diseases; Complication; Esophagus
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/1010-7940(92)90063-4

A prospective study to investigate the source of pathogenic organismsresponsible for infective complications of patients undergoing majoroesophageal surgery was undertaken in 138 consecutive patients (38 femaleand 100 male) with obstructive lesions of the oesophagus, aged 24 to 86years (mean 67 years). In all patients, the upper alimentary tract (UAT)was opened as part of the surgical procedure and 20.3% had pathogenspresent in their sputum before surgery. On direct culture of the contentsof stomach or oesophagus at operation, 61% showed pathogenic organisms.Twenty-five patients suffered from 28 infections, predominantlypleuropulmonary infection (n = 19) but also wound sepsis (n = 8) andgeneralised infection (n = 1). Pathogenic organisms could not be culturedfrom the tracheobronchial tree immediately postoperatively. There was nocorrelation between preoperative sputum microbiology and postoperativeinfection. There was, however, a definite correlation (66% of cases)between pathogens of UAT content collected at operation and thoseresponsible for postoperative infection. We conclude that it is relevantand important to regularly obtain samples of UAT content at operation toplan antibiotic regimes.