AORTIC GRAFT INFECTION .2. MICROBIOLOGY, TREATMENT, AND PREVENTION

Infection involving an aortic prosthesis is among the most challenging diagnostic and therapeutic complications in vascular surgery. Delays in diagnosis and treatment are associated with decreased patient survi val. Graft excision and revascularization by an extra-anatomic route o r autogenous repair is associated with a mortality of 15% to 20% and a n amputation rate of less than 10%. Carefully selected patients with l ate-appearing infection caused by Staphylococcus epidermidis can be sa fely treated by in situ graft. replacement. Early diagnosis, coupled w ith surgical intervention that eradicates the infectious process, are key elements for successful treatment. In the majority of patients, lo ng-term, infection-free survival, is possible but requires careful sur veillance for persistent or recurrent infection.