Is DTC necessary after paediatric cardiovascular surgery?

Positive drain tip cultures (DTC) do not have a significant association with the occurrence of surgical site infection (SSI) following paediatric cardiovascular surgery, according to a study.

Some 254 patients provided 555 samples for analysis. Positive DTC was found in 70 samples (12.6 percent), with 27 patients (10.6 percent) having at least one positive DTC. Staphylococcus epidermidis (n=44) was the most commonly isolated organism, followed by Candida parapsilosis (n=8), Staphylococcus lugdunensis (n=4), and Staphylococcus aureus (n=3).

SSIs developed in 20 patients (7.9 percent), with the SSI rate being higher in patients with positive DTC than those with negative DTC (14.8 percent vs 6.6 percent; p=0.13), albeit statistically nonsignificant. Among the samples analysed, only two showed consistent results between the organisms seen in DTC and those responsible for SSIs.

“Therefore, routine culture of drainage tube tips may not be necessary unless there are clinical signs of infection,” said the investigators, who conducted this retrospective, single-cohort study at a tertiary children’s hospital in Japan.

DTC and SSI data from paediatric patients who underwent cardiovascular surgery between December 2014 and August 2018 were analysed. The investigators collected demographic and clinical data, as well as compared the incidence of SSIs between patients with positive and negative DTC results.

“Further research is needed to evaluate the role of DTC in specific high-risk scenarios,” they said.