January 1984

Aortofemoral Graft Infection due to Staphylococcus epidermidis

Author Affiliations

From the Surgical Service, Veterans Administration Medical Center, Wood, Wis (Drs Bandyk and Towne) and Seattle (Drs Berni and Thiele), and the Department of Surgery, Medical College of Wisconsin, Milwaukee (Drs Bandyk and Towne).

Arch Surg. 1984;119(1):102-108. doi:10.1001/archsurg.1984.01390130084015

• A ten-year review of aortofemoral graft infection documented Staphylococcus epidermidis as the infecting organism in 18 (60%) of 30 cases. Diagnosis of such infection required a high index of suspicion because of its late postoperative appearance (mean interval of 41 months) and the inability to identify a microorganism at operation by routine wound culture or Gram's stain. Clinical findings suggesting graft infection included multiple anastomotic aneurysms (18 patients), perigraft exudate (16 patients), a draining groin mass (five patients), and aortoduodenal fistulas (two patients). Due to the low concentration and virulence of the organism, aerobic culture of the prosthetic fabric in broth media provided the optimum method of confirming the S epidermidis infection. Total graft excision with immediate vascular reconstruction was the preferred treatment method and resulted in a mortality and major amputation rate of 11%.

(Arch Surg 1984;119:102-108)