title: Different clinical utility of oropharyngeal bacterial screening prior to percutaneous endoscopic gastrostomy in oncological and neurological patients.
abstract: BACKGROUND
  The aim of this study was to monitor oropharyngeal bacterial colonization in patients indicated for percutaneous endoscopic gastronomy (PEG).
  
  
  METHODS
  Oropharyngeal swabs were obtained from patients prior to PEG placement. A development of peristomal infection was evaluated. The analysis of oropharyngeal and peristomal site pathogens was done.
  
  
  RESULTS
  Consecutive 274 patients referred for PEG due to neurological disorder or cancer completed the study. Oropharyngeal colonization with pathogens was observed in 69% (190/274), dominantly in the neurologic subgroup of patients (P < 0.001). Peristomal infection occurred in 30 (10.9%) of patients and in 57% of them the correlation between oropharyngeal and peristomal agents was present. The presence of oropharyngeal pathogens was assessed as an important risk factor for the development of peristomal infection only in oncological patients (OR = 8.33, 95% CI: 1.66-41.76). Despite a high prevalence of pathogens in neurological patients, it did not influence the risk of peristomal infection with the exception for methicillin resistant Staphylococcus aureus (MRSA) carriers (OR 4.5, 95% CI: 1.08-18.76).
  
  
  CONCLUSIONS
  During oropharyngeal microbial screening prior to the PEG insertion, the detection of pathogens may be a marker of the increased risk of peristomal infection in cancer patients only. In neurological patients the benefit of the screening is limited to the detection of MRSA carriers.
authors.affiliation: Department of Internal Medicine and Gastroenterology, University Hospital and Faculty of Medicine, Masaryk University Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
authors.forename: Radek
authors.identifier: 0000-0003-2315-8305
authors.initials: R
authors.lastname: Kroupa
authors.affiliation: Department of Clinical Microbiology, University Hospital, 625 00 Brno, Czech Republic ; Department of Laboratory Methods, Faculty of Medicine, Masaryk University Brno, 625 00 Brno, Czech Republic.
authors.forename: Jana
authors.identifier: 0000-0003-2401-0417
authors.initials: J
authors.lastname: Jurankova
authors.affiliation: Department of Internal Medicine and Gastroenterology, University Hospital and Faculty of Medicine, Masaryk University Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
authors.forename: Milan
authors.initials: M
authors.lastname: Dastych
authors.affiliation: Department of Internal Medicine and Gastroenterology, University Hospital and Faculty of Medicine, Masaryk University Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
authors.forename: Michal
authors.initials: M
authors.lastname: Senkyrik
authors.affiliation: Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic.
authors.forename: Tomas
authors.initials: T
authors.lastname: Pavlik
authors.affiliation: Department of Internal Medicine and Gastroenterology, University Hospital and Faculty of Medicine, Masaryk University Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
authors.forename: Jitka
authors.initials: J
authors.lastname: Prokesova
authors.affiliation: Department of Internal Medicine and Gastroenterology, University Hospital and Faculty of Medicine, Masaryk University Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
authors.forename: Marketa
authors.initials: M
authors.lastname: Jecmenova
authors.affiliation: Department of Internal Medicine and Gastroenterology, University Hospital and Faculty of Medicine, Masaryk University Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Dolina
authors.affiliation: Department of Internal Medicine and Gastroenterology, University Hospital and Faculty of Medicine, Masaryk University Brno, Jihlavska 20, 625 00 Brno, Czech Republic.
authors.forename: Ales
authors.initials: A
authors.lastname: Hep
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000382:microbiology; D002353:Carrier State / Q000382:microbiology; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology / Q000601:surgery*; D009960:Oropharynx / Q000382:microbiology*; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000401:mortality