The microbiological risk of invasive hemodynamic monitoring in adults undergoing cardiac valve replacement.

The microbiological risk of invasive hemodynamic monitoring was studied prospectively in 230 consecutive patients undergoing cardiac valve replacement during prophylactic therapy with cephalothin. A total of 923 catheter tips were cultured, and 1.6% yielded positive cultures. The rate of positive cultures did not differ significantly between catheters inserted percutaneously (1.9% positive) and those inserted surgically (0.5% positive). The incidence of positive catheter tip cultures for intravenous, central venous, arterial, and pulmonary arterial catheters was 0, 1.5, 2.6, and 2.9%, respectively, whereas the surgically inserted right and left atrial catheters yielded 0.6 and 0% positive tip cultures, respectively. One patient developed septicemia related to a right atrial catheter. There was no correlation between the incidence of positive catheter tip cultures and the length of time that the catheters remained in situ. No patient developed early or late endocarditis. Invasive hemodynamic monitoring seems to be microbiologically safe, even in patients undergoing cardiac valve replacement.