Farewell to bacteremia caused by endoscopic injection--effectiveness of a new injection catheter with a covered tip.
BACKGROUND
Endoscopic injection has recently been reported as effective for several treatments. Because the common channel (suction and biopsy) is usually contaminated with aspirated gastrointestinal juice containing bacteria, often the tip of the injector needle is also. We report a new catheter needle with a covered tip designed to prevent bacteremia from endoscopic injection.


METHODS
The new covered needle catheter (Clisco needle) has a 23-gauge retractable needle with a 3 mm extrusion in one lumen. Its distal tip is covered with rubber, blocking infiltration of contaminated gut juice. Ten of these catheters and 10 other disposable needles were inserted through the colonoscope's biopsy channel for 10 patients. Needle tips were cut off after extrusion, and bacteria cultured were counted by standard plate count method.


RESULTS
All cultures from ordinary needles grew Escherichia coli, whereas only 3 new needles grew E. coli. Average counts of bacteria cultured from these 3 catheters and 10 disposable needles were 1-250 and 90-6.1 x 10(6), respectively. The difference was highly significant (p < 0.0001).


CONCLUSIONS
This new covered needle catheter reduces contaminating bacteria in patients who require endoscopic injection and may prevent bacteremia without antibiotic prophylaxis.
Uno
Y
Y
First Department of Internal Medicine, Hirosaki University School of Medicine, Japan.
Munakata
A
A
Ohtomo
Y
Y
D016470:Bacteremia / Q000209:etiology / Q000517:prevention & control*; D002404:Catheterization / Q000295:instrumentation*; D020685:Colonoscopes; D003113:Colonoscopy / Q000009:adverse effects; D015169:Colony Count, Microbial; D004866:Equipment Contamination / Q000517:prevention & control*; D004867:Equipment Design; D004869:Equipment Safety; D004926:Escherichia coli / Q000254:growth & development*; D004927:Escherichia coli Infections / Q000517:prevention & control*; D006801:Humans; D012016:Reference Values