title: Low-frequency of bacteremia after endoscopic submucosal dissection of the stomach.
abstract: BACKGROUND
  Mainstream therapy for early gastric cancer in Japan has now shifted from endoscopic mucosal resection (EMR) to endoscopic submucosal dissection (ESD). Although bacteremia is reported as being infrequent and transient in gastric EMR, there are no reports of it being investigated in gastric ESD. This study aimed to determine the frequency of bacteremia in gastric ESD.
  
  
  METHODS
  A prospective study, in 46 consecutive patients who underwent gastric ESD, investigated the frequency of bacteremia before and after the procedure.
  
  
  RESULTS
  The median time for the total ESD procedure was 105min (range 30-400). The median volume of the submucosal injection was 80ml (range 20-260). The mean size of the resected specimen was 40±9.7mm. Blood cultures obtained before ESD were positive in 4.4% (2/45) of cases. Bacillus subtilis and Bacillus spp. were the isolated microorganisms. Blood cultures obtained 10min after ESD were positive in 4.3% (2/46) of cases; with the same microorganisms being isolated. Blood cultures obtained 3h after ESD were all negative. No signs of sepsis were seen in the two patients with a positive blood culture 10min after ESD.
  
  
  CONCLUSIONS
  The frequency of bacteremia after gastric ESD was low and transient. ESD for gastric lesions is thought to have a low risk of infectious complications; therefore, prophylactic administration of antibiotics may not be warranted.
authors.affiliation: Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Soichi
authors.initials: S
authors.lastname: Itaba
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Iboshi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakamura
authors.forename: Haruei
authors.initials: H
authors.lastname: Ogino
authors.forename: Yorinobu
authors.initials: Y
authors.lastname: Sumida
authors.forename: Akira
authors.initials: A
authors.lastname: Aso
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Yoshinaga
authors.forename: Hirotada
authors.initials: H
authors.lastname: Akiho
authors.forename: Hisato
authors.initials: H
authors.lastname: Igarashi
authors.forename: Masaki
authors.initials: M
authors.lastname: Kato
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kotoh
authors.forename: Tetsuhide
authors.initials: T
authors.lastname: Ito
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Takayanagi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000097:blood / Q000453:epidemiology*; D004210:Dissection / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged