Background: Epidural catheter-related infections are very rare, but if occurs, the complications are debilitating and life-threatening. The route by which the infection spreads is still under debate with the prime suspected route being direct spread with migration along the epidural catheter.
Objective: To critically analyze the incidence of epidural catheter-related infections, correlate the proposed risk factors leading to infection, and come up with a time frame at which the catheter should be ideally removed.
Material and Methods: A prospective observational study was done to study the incidence of epidural catheter-related infections and to find the bacteriological profile associated with epidural catheter-related infections. Ninety patients of ASA I and II aged between 18 and 65 years scheduled for elective surgeries requiring epidural catheter for intraoperative and postoperative analgesia were randomly allocated into three groups. Groups I, II, and III consisted of 30 patients each, and the epidural catheters were removed aseptically after 24, 48, and 72 h, respectively, and the catheter tips were sent for microbial culture examination.
Result: There was no incidence of epidural infections during the whole study. The incidence of bacterial colonization over epidural catheter tip in our study was 7.1% with “coagulase-negative Staphylococcus epidermidis” as the most common organism. Among the various risk factors studied, we found significant correlation only to that of the duration of catheter in situ with that of the positive catheter tip cultures, with 85.7% of the positive cultures from group III.
Conclusion: It is not advisable to allow the epidural catheters to be in situ for more than 72 h to avoid the chances of epidural catheter-related infections.
Key words: Bacterial colonization, epidural catheters, postoperative analgesia
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