Frequency of bacteremia after linear EUS of the upper GI tract with and without FNA.
BACKGROUND
Few data are available concerning the frequency of bacteremia after diagnostic EUS or EUS-guided FNA. This study was undertaken to provide these data and to determine whether present guidelines for prophylactic administration of antibiotics to prevent endocarditis during upper endoscopy are applicable to EUS and EUS-guided FNA.


METHODS
A total of 100 patients who were to undergo diagnostic EUS of the upper-GI tract and 50 who were to have upper-GI EUS-guided FNA were enrolled in this prospective study. Blood cultures were obtained before and within 5 minutes after the conclusion of the procedure. In case of bacterial growth, patients were observed for at least 3 days for signs of infection.


RESULTS
After diagnostic EUS, significant bacteremia was found in two patients with esophageal carcinoma (2%: 95% CI[0%, 4.8%]) and after EUS-guided FNA in two patients (4%: 95% CI[0%, 9.6%]). The difference was not statistically significant. None of these patients developed clinical signs of infection. Risk factors predisposing to bacteremia could not be identified.


CONCLUSIONS
The frequency of bacteremia after EUS, with and without FNA, is within the range of that for diagnostic upper endoscopy. Therefore, the same recommendations for prophylactic administration of antibiotics to prevent endocarditis may be applied in patients undergoing EUS and EUS-guided FNA. The role of esophageal cancer as a predisposing factor to EUS-associated infection remains uncertain.
Department of Medicine 2 and the Institute for Microbiology and Immunology, HELIOS Klinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany.
Jan
J
Janssen
Kerstin
K
König
Veronika
V
Knop-Hammad
Werner
W
Johanns
Lucas
L
Greiner
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D016470:Bacteremia / Q000453:epidemiology* / Q000517:prevention & control*; D001707:Biopsy, Needle / Q000009:adverse effects*; D001769:Blood / Q000382:microbiology*; D016001:Confidence Intervals; D004067:Digestive System Neoplasms / Q000175:diagnosis; D004697:Endocarditis, Bacterial / Q000517:prevention & control; D019160:Endosonography / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment