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(Radiology. 1999;212:669-672.)
© RSNA, 1999

Vascular and Interventional Radiology

Multiple Fluid Collections: CT- or US-guided Aspiration-Evaluation of Microbiologic Results and Implications for Clinical Practice1

Joan P. Heneghan, MD, Richard J. Everts, FRACP and Rendon C. Nelson, MD

1 From the Department of Radiology (J.P.H., R.C.N.) and the Clinical Microbiology Laboratory (R.J.E.), Duke University Medical Center, Erwin Rd, Box 3808, Durham, NC 27710. From the 1998 RSNA scientific assembly. Received November 25, 1998; revision requested December 30; final revision received January 24, 1999; accepted March 1. Address reprint requests to J.P.H. (e-mail: heneg002@mc.duke.edu).

PURPOSE: To determine if patients with multiple fluid collections need every collection aspirated and if cross-contamination is a risk if separate sterile procedures are not followed for each aspiration.

MATERIALS AND METHODS: Records from 1,076 imaging-guided percutaneous aspirations and drainages over 39 months were retrospectively reviewed; 124 patients had multiple fluid collections drained, which yielded 287 aspirates. The patients were divided into two groups: those (n = 82) with multiple collections aspirated on any 1 day, and those (n = 61) with multiple collections aspirated over 10 days. Nineteen patients were included in both groups. Gram stain microscopy and culture results were compared between sequential aspirates in each patient, and their potential effects on antimicrobial therapy and theoretic risk for cross-contamination were evaluated.

RESULTS: In 82 patients undergoing multiple aspirations on any 1 day, multiple microorganisms differed in 32 patients, which indicated a need for therapy change in 18 (22%) patients. In 61 patients undergoing aspiration on different days, microorganisms differed in 32 patients, which indicated a need for therapy change in 15 (25%) patients. Cross-contamination could have occurred in 28 of 93 (30%) aspirates from patients with a second or subsequent collection if separate sterile procedures had not been undertaken.

CONCLUSION: When multiple fluid collections are identified, aspirates from all collections should be obtained through separate sterile procedures to ensure optimal antimicrobial coverage and avoid cross-contamination.

Index terms: Abdomen, abscess, 70.201, 70.202, 70.204, 70.21, 70.1262 • Abscess, CT, 70.1211 • Abscess, US, 70.12986 • Pelvic organs, abscess, 80.201, 80.202, 80.204, 80.211, 80.1262