Concordance between Oropharyngeal Flora and Peristomal Wound Culture Bacteria Following Percutaneous Endoscopic Gastrostomy: A Prospective Cohort Study

Abstract

Objective: To examine the concordance between the oropharyngeal flora and peristomal wound culture bacteria following percutaneous endoscopic gastrostomy (PEG) placement. Methods: Cultures of oropharyngeal flora before PEG placement and peristomal wound cultures after PEG placement were examined prospectively in patients who underwent PEG between June 1, 2017, and June 1, 2019, at a local rehabilitation center. Microorganisms in the oropharyngeal flora and peristomal wound culture were identified, and the relationship between them was examined. The risk factors that may increase the PEG infection rate were also examined. Results: The predominant bacterium identified in the oropharyngeal flora and peristomal wounds in patients who required PEG was Pseudomonas aeruginosa. The concordance between the oropharyngeal flora and peristomal wound culture bacteria in patients with PEG infections was confirmed. Different oropharyngeal flora was observed in patients with a prolonged hospital stay compared to that of healthy adults. The concordance between the oropharyngeal flora and peristomal wounds was also identified with a high prevalence of gram-negative bacilli. There was no potential risk factor, such as comorbidities or length of hospitalization of patients associated with PEG infections. Conclusion: Because the oropharyngeal flora showed concordance with the bacteria found in the PEG stoma site, management of the oropharyngeal flora before PEG insertion should be considered for patients with dysphagia.