title: Current microbiology of percutaneous endoscopic gastrostomy tube (PEG tube) insertion site infections in patients with cancer.
abstract: OBJECTIVE
  Percutaneous endoscopic gastrostomy (PEG) is frequently used to provide enteral access in cancer patients who are unable to swallow. Infection is an important complication in this setting. Current microbiological data are needed to guide infection prevention and treatment strategies.
  
  
  METHODS
  The microbiological records of our institution (a 550-bed comprehensive cancer center) were retrospectively reviewed over an 8-month study period in order to identify patients who developed PEG tube insertion site infections, and review their microbiological details and susceptibility/resistance data.
  
  
  RESULTS
  Fifty-eight episodes of PEG tube insertion site infections were identified. Of these, 31 (53%) were monomicrobial, and the rest were polymicrobial. The most common organisms isolated were Candida species, Staphylococcus aureus, and Pseudomonas aeruginosa. All infections were local (cellulitis, complicated skin, and skin structure infections including abdominal wall abscess) with no cases of concomitant bacteremia being documented. Most of the organisms isolated were susceptible to commonly used antimicrobial agents, although some quinolone-resistant and some multidrug-resistant organisms were isolated.
  
  
  CONCLUSIONS
  This retrospective study provides descriptive data regarding PEG tube insertion site infections. These data have helped us update institutional guidelines for infection prevention and treatment as part of our focus on antimicrobial stewardship.
authors.affiliation: Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA. krolston@mdanderson.org
authors.forename: Kenneth V I
authors.initials: KV
authors.lastname: Rolston
authors.forename: Coralia
authors.initials: C
authors.lastname: Mihu
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Tarrand
mesh_terms: D003428:Cross Infection / Q000209:etiology / Q000382:microbiology*; D003680:Deglutition Disorders; D004750:Enteral Nutrition / Q000009:adverse effects*; D005774:Gastrostomy / Q000009:adverse effects*; D006801:Humans; D008826:Microbial Sensitivity Tests; D009369:Neoplasms / Q000523:psychology*; D012189:Retrospective Studies