Are systematic drain tip or drainage fluid cultures predictive of surgical site infections?

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Are systematic drain tip or drainage fluid cultures predictive of surgical site infections?

J Hosp Infect. 2018 Nov 27;:

Authors: Macaigne H, Ruggieri VG, L Vallet-Tadeusz, Vernet-Garnier V, Aho-Glélé LS, Bajolet O, Lefebvre A

Abstract
BACKGROUND: Systematic cultures of drain tips or drainage fluids for the early detection of surgical site infections (SSI) are controversial.
AIM: To examine the association between the results of systematic drain tip or drainage fluid cultures and the occurrence of SSI in clean or clean-contaminated surgery.
METHODS: We searched in the Pubmed, and Cat.inist databases for observational studies published before March 31st 2017. We included studies reporting results of drain tip or drainage fluid systematic cultures and SSI after clean or clean-contaminated surgeries, and we performed meta-analyses.
FINDINGS: Seventeen studies, including 4,390 patients for drain tip cultures and 1,288 for drainage fluid cultures, were selected. The pooled negative predictive values were high (99%, 95% CI [98-100] for drain tip cultures and 98%, 95% CI [94-100] for drainage fluid cultures). The positive predictive values were low (11%, 95% CI [2-24] for drain tip cultures and 12%, 95% CI [3-24] for drainage fluid cultures). The sensitivities were low (41%, 95% CI [12-73] for drain tip cultures and 37%, 95% CI [16-60] for drainage fluid cultures). The specificities were high (93%, 95% CI [88-96]) for drain tip cultures and moderate (77%, 95% CI [54-94]) for drainage fluid cultures.
CONCLUSION: Systematic cultures of drain tips or drainage fluids appear not to be relevant, because their positive predictive values were low in the prediction of SSI.

PMID: 30500389 [PubMed - as supplied by publisher]

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