Prospective risk assessment of bacteremia and other infectious complications in patients undergoing EUS-guided FNA.
BACKGROUND
There are few data regarding the risk of bacteremia with EUS-guided FNA. This study prospectively evaluated the frequency of bacteremia and other infectious complications after EUS-guided FNA.


METHODS
Patients referred for EUS-guided FNA of the upper GI tract lesions were considered for enrollment. Patients were excluded if there was an indication for preprocedure administration of antibiotics based on ASGE guidelines, had taken antibiotics within the prior 7 days, or if they had a pancreatic cystic lesion. Blood cultures were obtained immediately before the procedure, after routine endoscopy/radial EUS, and 15 minutes after EUS-guided FNA.


RESULTS
Fifty-two patients underwent EUS-guided FNA at 74 sites (mean 1.4 sites/patient) totaling 266 passes of the fine needle (mean 5.1 FNA/patient). Coagulase negative Staphylococcus was grown in cultures from 3 patients (5.8%; 95% CI [1%, 15%]) and was considered a contaminant. Three patients (5.8%; 95% CI [1%, 15%]) developed bacteremia: Streptococcus viridans (n = 2), unidentified gram-negative bacillus (n = 1). No signs or symptoms of infection developed in any patient.


CONCLUSIONS
EUS-guided FNA of solid lesions in the upper GI tract should be considered a low-risk procedure for infectious complications that does not warrant prophylactic administration of antibiotics for prevention of bacterial endocarditis.
Levy
Michael J
MJ
Division of Gastroenterology and Hepatology, Mayo Clinic Foundation, Rochester, Minnesota 55905, USA.
Norton
Ian D
ID
Wiersema
Maurits J
MJ
Schwartz
David A
DA
Clain
Jonathan E
JE
Vazquez-Sequeiros
Enrique
E
Wilson
Walter R
WR
Zinsmeister
Alan R
AR
Jondal
Mary Lou
ML
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000209:etiology*; D001707:Biopsy, Needle / Q000009:adverse effects; D004697:Endocarditis, Bacterial / Q000209:etiology*; D019160:Endosonography / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment