Objective To analyze the incidence, colonization pathways, and predictive factors of bacterial colonization of epidural analgesia catheters in patients with chronic pain.
Methods A total of 150 patients with chronic pain who underwent continuous epidural catheterization (catheter indwelling time of 7 to 10 days) were selected as study subjects. Samples from three sites were collected for bacterial culture. Clinical data of the patients were collected, and the positive rate of bacterial culture, characteristics of bacterial species distribution, and bacterial colonization pathways were analyzed. The efficacy of predictive factors was assessed using the receiver operating characteristic (ROC) curve.
Results The positive rates of bacterial culture in samples from the skin swabbing fluid around the puncture site, the subcutaneous segment of the catheter, and the catheter tip were 22.0%, 7.3%, and 8.7%, respectively. Staphylococcus epidermidis was the predominant colonizing bacterial species. Spearman correlation coefficient analysis showed a significant correlation between the results of bacterial culture from the skin around the puncture site and catheter tip colonization (r=0.47, P < 0.01). ROC curve analysis revealed that the area under the curve of bacterial culture results from the skin around the puncture site in predicting catheter tip bacterial colonization was 0.843, with a sensitivity of 84.9% and a specificity of 84.6%.
Conclusion Bacterial migration along the catheter is the main pathway for catheter tip bacterial colonization, and the results of bacterial culture from the skin around the puncture site are an effective predictive factor for the risk of bacterial colonization.
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