Bacterial colony counts during vaginal surgery

• Authors: Michael Heit, Emory University; P Culligan, University of Louisville Health Sciences Center; L Blackwell, University of Louisville Health Sciences Center; M Murphy, University of Louisville Health Sciences Center; CA Graham, University of Louisville Health Sciences Center; J Snyder, University of Louisville Health Sciences Center
• Journal Title: Infectious Disease in Obstetrics and Gynecology
• Volume: Volume 11, Number 3
• Publisher: (publisher) | 2003-12-31, Pages 161-165
• Type of Work: Article
• Publisher DOI: http://doi.org/10.1080/10647440300025515
• Keywords: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacteria, Aerobic; Bacteria, Anaerobic; Colony Count, Microbial; Female; Follow-Up Studies; Humans; Hysterectomy; Middle Aged; Monitoring, Intraoperative; Postoperative Care; Preoperative Care; Risk Assessment; Sampling Studies; Surgical Wound Infection; Treatment Outcome; Vaginosis, Bacterial

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.