title: High rate of percutaneous endoscopic gastrostomy site infections due to oropharyngeal colonization.
abstract: We prospectively analyzed peristomal infection agents during the first week following percutaneous endoscopic gastrostomy (PEG) placement by the pull technique in patients with head and neck cancer. Nasal and pharyngeal swabs were obtained from a consecutive series of cancer patients prior to PEG placement. All patients underwent antibiotic prophylaxis with cefotaxime and oral disinfection. PEG site infection was prospectively evaluated at days 2, 3, and 7 after insertion. Twenty-eight patients (25 males; mean age, 58 years) were included. Oropharyngeal or nasal colonization were observed in 68% (19/28) and 19% (5/28) of patients, respectively. Early infections occurred in 36% (10/28) of the patients, all with oropharyngeal colonization and concordance between agents (P=0.01). Three patients required hospital admission and 1 required surgery. Head and neck cancer patients with oropharyngeal colonization have a high risk of early PEG site infection with substantial morbidity owing to oral-stomal spread.
authors.affiliation: Gastrenterology Department, Instituto Português de Oncologia de Francisco Gentil, CRL - Lisbon, Portugal.
authors.forename: Sandra
authors.initials: S
authors.lastname: Faias
authors.forename: Marília
authors.initials: M
authors.lastname: Cravo
authors.forename: Isabel
authors.initials: I
authors.lastname: Claro
authors.forename: Pedro
authors.initials: P
authors.lastname: Lage
authors.forename: Carlos
authors.initials: C
authors.lastname: Nobre-Leitão
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000209:etiology*; D002176:Candida albicans; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000628:therapy; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D009960:Oropharynx / Q000382:microbiology*; D015995:Prevalence; D011446:Prospective Studies; D011550:Pseudomonas aeruginosa; D012307:Risk Factors; D013211:Staphylococcus aureus; D054047:Surgical Stomas / Q000382:microbiology*; D013530:Surgical Wound Infection / Q000209:etiology / Q000382:microbiology