Prospective study of bacteremia rate after elastic band ligation and sclerotherapy of esophageal varices in patients with hepatosplenic schistosomiasis

Röhr, Maria Rachel da Silveira; Siqueira, Eduardo Sampaio; Brant, César Q.; Morais, Madelon; Líbera, Ermelindo Della; Castro, Rubem Robson Oliveira; Ferrari, Ângelo Paulo

doi:10.1016/s0016-5107(97)70118-4

Cited by 28 publications

(15 citation statements)

References 10 publications

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“…The incidence of bacteremia after BL in the present study is similar that was found in another research performed in your service, 13 years ago (5.7%) (4) . A review investigating the association between BL and bacteremia showed that the latter was more frequent among patients with severe liver disease.…”

Section: Discussionsupporting

confidence: 92%

Prospective study of bacteremia rate after elective band ligation and sclerotherapy with cyanoacrylate for esophageal varices in patients with advanced liver disease

Bonilha

Correia

Monaghan

et al. 2011

Arq. Gastroenterol.

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-Context -Band ligation (BL) is the most appropriate endoscopic treatment for acute bleeding or prophylaxis of esophageal variceal bleeding. Sclerotherapy with N-butyl-2-cyanoacrylate (CY) can be an alternative for patients with advanced liver disease. Bacteremia is an infrequent complication after BL while the bacteremia rate following treatment with CY for esophageal varices remains unknown. Objectives -To evaluate and compare the incidence of transient bacteremia between cirrhotic patients submitted to diagnostic endoscopy, CY and BL for treatment of esophageal varices. Methods -A prospective study comprising the period from 2004 to 2007 was conducted at Hospital of Universidade Federal de São Paulo, UNIFESP, SP, Brazil. Cirrhotic patients with advanced liver disease (Child-Pugh B or C) were enrolled. The patients were divided into two groups according treatment: BL Group (patients undergoing band ligation, n = 20) and CY Group (patients receiving cyanoacrylate injection for esophageal variceal, n = 18). Cirrhotic patients with no esophageal varices or without indication for endoscopic treatment were recruited as control (diagnostic group n = 20). Bacteremia was evaluated by blood culture at baseline and 30 minutes after the procedure. Results -After 137 scheduled endoscopic procedures, none of the 58 patients had fever or any sign suggestive of infection. All baseline cultures were negative. No positive cultures were observed after CY or in the control group -diagnostic endoscopy. Three (4.6 %) positive cultures were found out of the 65 sessions of band ligation (P = 0.187). Two of these samples were positive for coagulase-negative staphylococcus, which could be regarded as a contaminant. The isolated microorganism in the other case was Klebsiella oxytoca. The patient in this case presented no evidence of immunodeficiency except liver disease. Conclusions -There was no significant difference in bacteremia rate between these three groups. BL or CY injection for non-bleeding esophageal varices may be considered as low-risk procedures regarding bacteremia even when performed on patients with advanced liver disease.

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Section: Discussionsupporting

confidence: 92%

Prospective study of bacteremia rate after elective band ligation and sclerotherapy with cyanoacrylate for esophageal varices in patients with advanced liver disease

Bonilha

Correia

Monaghan

et al. 2011

Arq. Gastroenterol.

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“…We do not consider that our findings support the administration of antibiotic prophylaxis before all urgent OI. However, the incidence of bacteremia after a difficult intubation is the same as the incidence after sclerotherapy for esophageal varices for which antibiotic prophylaxis is recommended [4,10]. The usefulness of giving antibiotics for endocarditis prophylaxis after the procedure, e.g., when the intubation proved to be difficult, is not clear but experimental streptococcal endocarditis could be prevented with a single dose of amoxicillin given after the bacterial challenge [11].…”

Section: Discussionmentioning

confidence: 99%

“…Sclerotherapy of esophageal varices causes bacteremia in 4.5±31.6 % of patients, and dilation of esophageal stenosis causes bacteremia in 20 % of the procedures [4,5,6,7].…”

Section: Introductionmentioning

confidence: 99%

Frequency of transient streptococcal bacteremia following urgent orotracheal intubation in critically ill patients

et al. 2001

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“…Despite conflicting reports [19][20][21], the risks of bacteremia and serious infectious complications are believed to be very low after VBL, compared with variceal sclerotherapy. Nagamine et al [22] evaluated these risks in a prospective study of 20 cirrhotic patients undergoing VBL.…”

Section: Risk Of Bacteremia After Variceal Band Ligation (Ddw)mentioning

confidence: 99%

Management of esophageal varices: An update from Digestive Disease Week and American Association for the Study of Liver Diseases 2003

Gawrieh

Saeian

2004

Curr Gastroenterol Rep

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Esophageal varices are a commonly encountered complication of cirrhosis. beta-blockers are a well-established cornerstone of the treatment of portal hypertension and primary and secondary prophylaxis for prevention of esophageal variceal bleeding. However, not all patients tolerate this type of therapy. Moreover, the exact role of esophageal variceal band ligation alone or in combination with beta-blocker therapy in the management of patients with esophageal varices remains to be defined. This summary report presents a number of recent studies addressing these important issues.

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Prospective study of bacteremia rate after elastic band ligation and sclerotherapy of esophageal varices in patients with hepatosplenic schistosomiasis

Cited by 28 publications

References 10 publications

Prospective study of bacteremia rate after elective band ligation and sclerotherapy with cyanoacrylate for esophageal varices in patients with advanced liver disease

Prospective study of bacteremia rate after elective band ligation and sclerotherapy with cyanoacrylate for esophageal varices in patients with advanced liver disease

Frequency of transient streptococcal bacteremia following urgent orotracheal intubation in critically ill patients

Management of esophageal varices: An update from Digestive Disease Week and American Association for the Study of Liver Diseases 2003

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