[Contribution of nasal methicillin-resistant Staphylococcus aureus colonization to percutaneous endoscopic gastrostomy site infection and risk factors of wound infection].
OBJECTIVE
Peristomal infection is the most common complication of percutaneous endoscopic gastrostomy (PEG) insertion. Methicillin-resistant Staphylococcus aureus (MRSA) is the most commonly implicated organism of peristomal infection. The aims of this study were to determine the contribution of nasal MRSA to wound infection in PEG and the predictors of wound infection.


METHODS
A prospective study was conducted on patients undergoing PEG between September 2003 and July 2005. All patients received antibiotics prior to PEG insertion. Nasal swabs were taken from a consecutive series of patients prior to PEG insertion. Wound status of the peristomal site were prospectively evaluated at day 1, 3, and 7 following the insertion of PEG.


RESULTS
Thirty-one patients underwent PEG insertion (mean age, 66+/-16 years). Ten patients (32.3%) had MRSA-positive nasal swabs. Peristomal infection did not have any relationship with nasal MRSA colonization (p>0.05). Peristomal infection occurred in 4 (12.9%) cases. The rate of peristomal infections was significantly higher in patients with diabetes mellitus (p<0.05).


CONCLUSIONS
Nasal MRSA colonization is not associated with the risk of peristomal infections in patients receiving antibiotics prior to PEG insertion. Diabetes mellitus might be the risk factor for peristomal infection after PEG insertion.
Oh
Hee Jung
HJ
Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University College of Medicine, Seoul, Korea.
Shim
Ki-Nam
KN
Choi
Hee Jung
HJ
Lee
Jong-Soo
JS
Song
Hyun Joo
HJ
Ryu
Kum Hei
KH
Kim
Tae Hun
TH
Jung
Sung-Ae
SA
Yoo
Kwon
K
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D005773:Gastroscopy; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008712:Methicillin / Q000494:pharmacology; D016106:Methicillin Resistance; D008875:Middle Aged; D009666:Nose / Q000382:microbiology; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*
D000900:Anti-Bacterial Agents; D008712:Methicillin