Bacteremia Following Operative Endoscopy of the Upper Gastrointestinal Tract

Abstract

The rate of bactaeremia following surgical endoscopy of the upper gastrointestinal tract is reported with up to 50% depending on the therapeutic measure performed. In a prospective study we examined 160 patients treated by surgical endoscopy of the upper digestive tract. The rate of bactaeremia showed a significant difference with 12.5% after diagnostic and 28.96% after surgical endoscopy. Our results recommend a single shot antibiotic prophylaxis depending on the endoscopic measure performed and the patient's individual risk.

Transmission of Infection by Flexible Gastrointestinal Endoscopy and Bronchoscopy

“…The reported incidence of bacteremia after diagnostic upper GI endoscopy, with or without biopsies, was less than 8% (207)(208)(209)(210)(211)(212)(213)(214)(215). The isolated microorganisms included mainly Staphylococcus epidermidis and Streptococcus spp.…”

“…These endoscopic procedures are frequently performed in the setting of acute bleeding or a benign or malignant stricture of the esophagus and have a higher rate of bacteremia (30%) than diagnostic endoscopic procedures (12.5%) (214). The incidence of transient bacteremia ranges from 0% to 53% after esophageal sclerotherapy (65,(217)(218)(219)(220)(221)(222)(223)(224)(225), from 1% to 25% after endoscopic variceal ligation (211,217,219,226), and from 2% to 54% after esophageal dilatation (227-230).…”

Safety of technology: Infection control standards in endoscopy

“…36,37 Endoscopic retrograde cholangiopancreatography is associated with bacteremia in up to 50% of cases. 38 Although bacteremia during endoscopy is transient, usually peaking at 5 min and then decreasing rapidly thereafter, it may be responsible for clinical infections in patients with obstructed biliary systems or in immunocompromised individuals. The American Society for Gastrointestinal Endoscopy recommends the use of antibiotic prophylaxis in patients with prosthetic valves, history of endocarditis, systemicpulmonary shunt, or synthetic vascular graft (less than 1 year old) when undergoing procedures with a high rate of bacteremia.…”

“…Sterilization of dilators almost completely abolished the bacteremia associated with stricture dilatation, while the use of shorter needles and sterile water reduced that associated with sclerotherapy 36,37 . Endoscopic retrograde cholangiopancreatography is associated with bacteremia in up to 50% of cases 38 . Although bacteremia during endoscopy is transient, usually peaking at 5 min and then decreasing rapidly thereafter, it may be responsible for clinical infections in patients with obstructed biliary systems or in immunocompromised individuals.…”

Endoscopy‐related infections

“…Endoscopic biopsy does not seem to increase the incidence of bacteraemia, but other therapeutic interventions, such as oesophageal dilation or laser treatment, may. In five studies of bacteraemia following oesophageal dilation, bacteraemia occurred a n average of 45 % of the timel3, 20,21,[27][28][29] with one study reporting bacteraemia in 100% of patients.2s Combining the results of two studies in which dilators were disinfected, the incidence of bacteraemia decreased from 39 % to 21 % when the dilators were scrubbed with 7.5 % povidone-iodine for 30 sec or 2% glutaraldehyde for 60 sec prior to the procedure.13* 28 There have been two reported cases of endocarditis following bougie dilation of oesophageal strictures. One occurred in a patient with mitral valve prolapse and another in a patient with rheumatic heart disease who had other potential sources of bacteraemia.30v 31 Bacteraemia following upper endoscopic laser treatment has been reported to be as high as 35%, however no clinical infections have resulted from this procedure.21* 32…”