Increased risk of peristomal wound infection after percutaneous endoscopic gastrostomy in patients with diabetes mellitus

Lee, J.H.; Kim, J.J.; Kim, Y.-H.; Jang, Jieun; Son, Hee Jung; Peck, Kyong Ran; Rhee, Poong–Lyul; Paik, S.W.; Rhee, Jong Chul; Choi, Kae Won

doi:10.1016/s1590-8658(02)80256-0

Cited by 52 publications

(31 citation statements)

References 23 publications

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“…In previous series the rate of wound infection may differ significantly between 5% and 39% (13,14,21) . In our study, the overall peristomal infection rate was 12.1%, an intermediate figure, but rising every year and over 25% in 2010.…”

Section: Discussionmentioning

confidence: 86%

“…Most PEG patients have multiple hospitalization episodes prior to the gastrostomy procedure, multiplying the chances of becoming colonized by multiresistant organisms. The use of broad-spectrum antibiotics before PEG insertion (13) may also be an explanation for the high prevalence of Pseudomonas aeruginosa (30.6%). Taking into consideration the rising of nosocomial infection and multiresistant bacteria, namely MRSA, in hospitals worldwide, we believe that in the future these agents will become more and more important in peristomal infection.…”

Section: Discussionmentioning

confidence: 99%

“…Peristomal wound infection occurs in 5% to 39% of patients and is the most frequent PEG complication (13,21) . The increasing incidence of resistant organisms in hospitals and long term care facilities justifies, nowadays, the clinical impact of these infections (4,14) .…”

Section: Peristomal Infection After Percutaneous Endoscopic Gastrostomentioning

confidence: 99%

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Peristomal infection after percutaneous endoscopic gastrostomy: a 7-year surveillance of 297 patients

Duarte

Santos

Capelas

et al. 2012

Arq. Gastroenterol.

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-Context -Healthcare-associated infection represents the most frequent adverse event during care delivery. Medical advances like percutaneous endoscopic gastrostomy have brought improvement on quality of life to patients but an increased risk of healthcare-associated infection. Predictive risk factors for peristomal wound infection are largely unknown but evidence suggests that antibiotic prophylaxis and preventive strategies related to infection control may reduce infection rates. Objectives -The primary aim was to evaluate the global prevalence rate of peristomal infection. Secondary objectives were to characterise the positive culture results, to evaluate the prophylactic antibiotic protocol and to identify potential risk factors for peristomal infection. Methods -Retrospective study of 297 patients with percutaneous endoscopic gastrostomy performed at a general hospital between January 2004 and September 2010. Patients received prophylactic cefazolin before the endoscopic gastrostomy procedure. Medical records were reviewed for demographic data, underling disease conditions to percutaneous endoscopic gastrostomy and patient potential intrinsic risk factors. Statistical analysis was made with the statistical program SPSS 17.0. Results -A total of 297 percutaneous endoscopic gastrostomy tubes were inserted. Wound infection occurred in 36 patients (12.1%). Staphylococcus aureus methicillin resistant was the most frequently isolated microorganism (33.3%) followed by Pseudomonas aeruginosa (30.6%). The incidence rate had been rising each year and differ from 4.65% in 2004/2007 to 17.9% in 2008/2010. This finding was consistent with the increasing of prevalence global infection rates of the hospital. Most of the infections (55.6%) were detected in the first 10 days post procedure. There was no significant difference in age, body mass index values, mean survival time and duration of percutaneous endoscopic gastrostomy feeding between patients with and without periostomal infection. Institutional factors, namely global prevalence infection rates and the endemic character of Staphylococcus aureus methicillin resistant, play an important role in peristomal infection rates. Traditional antibiotic prophylaxis with cefazolin is not adequate due to the prevalence of resistant organisms. Conclusions -Peristomal infection is a frequent problem with clinical impact in percutaneous endoscopic gastrostomy patients and should be considered a healthcare associated infection. The antimicrobial prophylaxis regimens using cephalosporins are not adequate and need to be reviewed due to the high prevalence of Staphylococcus aureus methicillin resistant and other resistant organisms in hospitals and nursing homes.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

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Peristomal infection after percutaneous endoscopic gastrostomy: a 7-year surveillance of 297 patients

Duarte

Santos

Capelas

et al. 2012

Arq. Gastroenterol.

View full text Add to dashboard Cite

show abstract

“…In addition, after performing PEG in such cases, it is necessary to finely control the infusions and medications by performing frequent blood or X-ray tests. Previous studies have reported that patients with diabetes or low body weight have a high frequency of complications [24,25] . However, body mass index, fasting blood sugar levels and the presence of diabetes mellitus were not identified as predictors of enteral nutrition problems after PEG.…”

Section: Discussionmentioning

confidence: 99%

Investigation and prediction of enteral nutrition problems after percutaneous endoscopic gastrostomy

Yokohama¹,

Aoshima²,

Nakade³

et al. 2009

WJG

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“…Additionally, loosening of the external bolster can allow migration of the internal bumper through the pylorus into the small bowel, mimicking small bowel obstruction (Hoffer et al, 1999;Mollitt et al, 1998;Schrag et al, 2007). Wound Infection is a common occurrence, with local infection found to occur in up to 23% of cases (Lee et al, 2002). The majority of infections (>70%) are minor (Gossner et al, 1999).…”

Section: Complications Of Percutaneous Endoscopic Gastrostomymentioning

confidence: 99%

Percutaneous Endoscopic Gastrostomy in Neurological Patients

Burke¹,

Geller²

2011

Gastrostomy

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Increased risk of peristomal wound infection after percutaneous endoscopic gastrostomy in patients with diabetes mellitus

Cited by 52 publications

References 23 publications

Peristomal infection after percutaneous endoscopic gastrostomy: a 7-year surveillance of 297 patients

Peristomal infection after percutaneous endoscopic gastrostomy: a 7-year surveillance of 297 patients

Investigation and prediction of enteral nutrition problems after percutaneous endoscopic gastrostomy

Percutaneous Endoscopic Gastrostomy in Neurological Patients

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