Effects of prolonged stay in hospital on gastric flora

Objective: To find out if a long preoperative stay in hospital results in the introduction of micro‐organisms into the gastric flora that are resistant to the usual perioperative chemoprophylaxis. Design: Observational study. Setting: Teaching hospital, Greece. Subjects: 145 consecutive patients admitted for abdominal or pelvic operations. Interventions: Aspiration of gastric fluid for measurement of pH and culture. Main outcome measures: Growth and type of pathogens in gastric aspirate. Results: 125 patients spent a mean (range) of 13.6 days (7–69) in hospital preoperatively and 20 patients spent 3.1 (1–7) days. In the long‐stay group 103 had a gastric pH of <4 and in 22 it was 4 or more; in 40 patients pathogens were grown from the gastric aspirate but resistant Pseudomonas cepacia was grown from only 2. In the short‐stay group 16 patients had a pH of <4 and in 4 it was 4 or more; in 4 patients pathogens were grown from the aspirate. Conclusion: Prolonged stay in hospital preoperatively does not seem to affect the gastric flora, so routine chemoprophylaxis should be sufficient in abdominal operations. Copyright © 1999 Taylor and Francis Ltd.