Port-site tuberculosis after laparoscopy

Ramesh, H.; Kurumboor, Prakash; Lekha, V.; Jacob, George; Venugopal, A.; Venugopal, Balaji

doi:10.1007/s00464-002-9057-6

Cited by 33 publications

(31 citation statements)

References 11 publications

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“…Usually the current practice in India is to immerse instruments in 2-2.5% glutaraldehyde solution for 20 minutes which achieves disinfection but not sterilization. 12 Furthermore, the source of infection is often the boiled tap water used for cleansing of the instruments after immersion in glutaraldehyde.…”

Section: Discussionmentioning

confidence: 99%

Atypical mycobacterial infection in post laparoscopy surgical wounds: our observations and review of literature

Kumar

Samarasam

2017

Int Surg J

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Background: Nontuberculous mycobacteria (NTM) are a rare cause of chronic surgical infection in humans. These infections are commonly seen in the setting of laparoscopic surgery, due to poor sterilization techniques. This case series analyses the clinical features and management of patients with biopsy proven NTM infection, with a review of the current literature.Methods: Patients with chronic surgical site infections admitted to our surgical unit, over a 5-year period from January 2008 to December 2012 were analyzed in this study. A total of 24 patients with biopsy proven NTM were included. The clinical details, management protocol is discussed.Results: A total of 24 patients were analysed. Most of our patients were females (n=16) and this infection was most commonly seen following laparoscopic cholecystectomy (n=10). The symptoms were usually benign but persistent watery or purulent discharge. Mycobacterium fortuitum and Mycobacterium chelonae were the predominant organisms isolated. All patients in this series were treated with extensive surgical debridement and long-term antibiotics. A multidrug antibiotic regimen consisting of Ciprofloxacin, Clarithromycin and Amikacin was used. All of our patients showed good response to treatment during stay and recurrence was seen in 3 patients who had delayed healing wounds.Conclusions: NTM is not an uncommon infection and can occur following laparoscopic or open surgical procedures. Improper sterilization and reuse of laparoscopic or open instruments accounts for the majority of the cases. When laparoscopic instruments are reused, following strict sterilization protocols is necessary to prevent this infection. When established, this infection should be treated aggressively with adequate surgical debridement, followed by long term antibiotics.

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Section: Discussionmentioning

confidence: 99%

Atypical mycobacterial infection in post laparoscopy surgical wounds: our observations and review of literature

Kumar

Samarasam

2017

Int Surg J

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“…Thus, the standard sterilization procedure has been a 20 minute exposure to 2.0-2.5% glutaraldehyde. At the current exposure time, these solutions act as high level disinfectants and not sterilants thus allowing bacterial endospores to survive [12]. Current guidelines on infection control recommend a minimum exposure time of 8-12 hours to achieve the desired level of sporicidal activity of these germicides and the use of higher concentrations (3.4%) of glutaraldehyde disinfectants.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Management of Atypical Mycobacterial Infection after Laparoscopic Surgery

2010

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Atypical mycobacterial infections at the laparoscopic port site are a frequent problem encountered in patients undergoing laparoscopic surgery. In this study we concentrate on the clinical diagnosis, management and prevention of this problem. In this series we assess 19 patients presenting with port hole infections after laparoscopic surgery and were treated with a combination of oral clarithromycin and ciprofloxacin. Seven patients who had persistent nodules were given injections of amikacin directly into the infection foci along with standard oral therapy. Most of the patients treated with standard oral therapy for 28 days showed recovery. The patients with persistent nodules 4 weeks after completion of therapy were treated with injections of amikacin directly into the nodule which lead to resolution of symptoms. For prevention of infection, proper sterilization and storage of instruments is recommended. Laparoscopic port hole infections is a preventable problem and can also be treated by nonsurgical method.

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“…Ramesh et al reported eight patients with biopsy-proven tuberculosis at the port site unassociated with other clinical features of tuberculosis following cholecystectomy. 4 Three of the eight patients had positive culture for Mycobacterium tuberculosis. Jagadish et al reported one such case.…”

Section: Discussionmentioning

confidence: 96%