Prospective Assessment of Risk of Bacteremia Following Colorectal Stent Placement

Abstract

Colorectal stent insertion does not induce significant bacteremia in patients with colorectal obstruction. These findings suggest that the routine use of prophylactic antibiotics may not be necessary in colorectal stent insertion.

ASGE review of adverse events in colonoscopy

“…Bacteremia is uncommon (6.3%) even after therapeutic colon procedures such as colonic stent insertion. 73 Although individual cases of infection after colonoscopy have been reported, there is no definite causal link with the endoscopic procedure and no proven benefit for antibiotic prophylaxis. 74 Therefore, current guidelines from the American Heart Association and ASGE recommend against antibiotic prophylaxis for patients undergoing colonoscopy.…”

Antibiotic prophylaxis for GI endoscopy

“…17 Bacteremia is uncommon (6.3%) even with therapeutic colon procedures such as colonic stent insertion. 21 The rate of bacteremia with flexible sigmoidoscopy is ! 1%.…”

Population-Based Epidemiology and Microbiology of Community-Onset Bloodstream Infections

“…Second, implicit within the term "bloodstream infection" is that the positive blood culture is associated with clinical infection. While most bacteremias are associated with infections, transient bacteremias may occasionally be observed following minor manipulations of nonsterile body surfaces that are not infection associated (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26).…”

“…Transient bacteremia is a "true" bacteremia in that viable organisms are present in the bloodstream (i.e., not contaminants), but it is not a BSI because it is not infection associated. There are a number of well-recognized causes of transient bacteremia, and these generally involve manipulation of colonized or contaminated mucosal surfaces, including dental manipulations (16)(17)(18)(19), endoscopic gastrointestinal procedures (20)(21)(22)(23), and invasive respiratory procedures (24,25). Transrectal needle prostate biopsy is associated with transient bacteremia in approximately 20% of cases, and this may subsequently evolve into BSI (26).…”