Peristomal wound infections are common complications of percutaneous endoscopic gastrostomy.
They occur especially in hospitals where methicillin-resistant Staphylococcus aureus (MRSA) is endemic.
Evidence suggests that antibiotic prophylaxis at percutaneous endoscopic gastrostomy insertion may reduce infection rates.
Dr Alistair McIntyre and colleagues from the United Kingdom examined rates of peristomal methicillin-resistant Staphylococcus aureus infection before and after screening programs.
The team also examined peristomal methicillin-resistant Staphylococcus aureusinfection rates before and after an antibiotic prophylaxis protocol.
The team conducted a retrospective analysis to detect new peristomal methicillin-resistant Staphylococcus aureus infections over 33 months.
Patients requiring percutaneous endoscopic gastrostomy were screened from 2004.
|Peristomal MRSA infection occured in 29% during 2004|
|Alimentary Pharmacology & Therapeutics|
Methicillin-resistant Staphylococcus aureus positive patients received decontamination, and prophylactic teicoplanin before insertion.
The researchers monitored peristomal wound sites after insertion.
Peristomal methicillin-resistant Staphylococcus aureus infection was identified in 12% of patients in 2002, 20% in 2003, and 29% in 2004.
The team observed that the overall infection rate was 19%.
The research team reported that 47 patients underwent new percutaneous endoscopic gastrostomy insertions between 2004 and 2006.
Of these patients, 2% developed peristomal methicillin-resistant Staphylococcus aureus infection 14 days postprocedure.
A significant reduction in methicillin-resistant Staphylococcus aureus peristomal infection has been demonstrated.
Dr McIntyre's team concludes, “Screening for methicillin-resistant Staphylococcus aureus before percutaneous endoscopic gastrostomy insertion identifies colonization.”
“Subsequent decontamination and antibiotic prophylaxis reduces peristomal methicillin-resistant Staphylococcus aureus infection rates.”
“Where methicillin-resistant Staphylococcus aureus is endemic, the risk of wound site infection may remain postprocedure unless high standards of wound care are maintained.”