The relationship between intraoperative contamination of the lower respiratory tract and postoperative chest infection

The relationship between intraoperative contamination of the lower respiratory tract and postoperative chest infection was studied in 193 patients undergoing biliary tract surgery. During surgery, sputum was obtained from the lower respiratory tract for bacteriological culture. The diagnosis of postoperative pulmonary complications was based on clinical criteria, supported by the pattern of sequential blood gas changes in the postoperative period. Chest infection was present in 30% of patients who harboured Haemophilus species in their sputum at the time of surgery compared with 10% of those with negative cultures. Contamination of the lower respiratory tract at operation by Haemophilus sp. is associated with development of postoperative chest infection.