Bacteremia during esophageal variceal sclerotherapy: its cause and prevention

Brayko, Craig M.; Kozarek, Richard A.; Sanowski, Robert A.; Testa, Anna

doi:10.1016/s0016-5107(85)71955-4

Cited by 62 publications

(20 citation statements)

References 22 publications

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“…Many outbreaks of P. aeruginosa infection after GI endoscopy and bronchoscopy have been associated with inadequate cleaning and the use of inappropriate intermediate-level and low-level disinfectants (29,62,64,73,80,90,(95)(96)(97)(98), contaminated endoscope water bottles and the water supply to the endoscope (29,65,90,99,100), and drying of endoscope channels with no flushing with 70% ethanol after disinfection (22,30,70,(73)(74)(75) or lack of a drying procedure (26,64) (Tables 2 to 5). Two recent outbreaks of multidrug-resistant P. aeruginosa post-ERCP infections have been related to the remaining contamination of the endoscope despite accurate reprocessing followed by negative surveillance endoscope cultures (2,101).…”

Section: Bacteriamentioning

confidence: 99%

“…These endoscopic procedures are frequently performed in the setting of acute bleeding or a benign or malignant stricture of the esophagus and have a higher rate of bacteremia (30%) than diagnostic endoscopic procedures (12.5%) (214). The incidence of transient bacteremia ranges from 0% to 53% after esophageal sclerotherapy (65,(217)(218)(219)(220)(221)(222)(223)(224)(225), from 1% to 25% after endoscopic variceal ligation (211,217,219,226), and from 2% to 54% after esophageal dilatation (227-230).…”

Section: Diagnostic and Therapeutic Upper Gastrointestinal Endoscopymentioning

confidence: 99%

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Transmission of Infection by Flexible Gastrointestinal Endoscopy and Bronchoscopy

et al. 2013

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SUMMARY Flexible endoscopy is a widely used diagnostic and therapeutic procedure. Contaminated endoscopes are the medical devices frequently associated with outbreaks of health care-associated infections. Accurate reprocessing of flexible endoscopes involves cleaning and high-level disinfection followed by rinsing and drying before storage. Most contemporary flexible endoscopes cannot be heat sterilized and are designed with multiple channels, which are difficult to clean and disinfect. The ability of bacteria to form biofilms on the inner channel surfaces can contribute to failure of the decontamination process. Implementation of microbiological surveillance of endoscope reprocessing is appropriate to detect early colonization and biofilm formation in the endoscope and to prevent contamination and infection in patients after endoscopic procedures. This review presents an overview of the infections and cross-contaminations related to flexible gastrointestinal endoscopy and bronchoscopy and illustrates the impact of biofilm on endoscope reprocessing and postendoscopic infection.

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Section: Bacteriamentioning

confidence: 99%

Section: Diagnostic and Therapeutic Upper Gastrointestinal Endoscopymentioning

confidence: 99%

Transmission of Infection by Flexible Gastrointestinal Endoscopy and Bronchoscopy

et al. 2013

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“…However, when endoscopy is followed by more invasive procedures such as esophageal variceal sclerotherapy (EVS), a variable incidence of bacteremia is reported (7,9,11,12,20,21,25,40,45,50) . Considering that in recent years EVL has replaced EVS in the treatment of esophageal varices, and that only a few studies have analyzed the presence of bacteremia after EVL (21,24,25,40,55) , this study aimed at investigating the incidence of bacteremia in cirrhotics submitted to such therapeutic procedure.…”

Section: Discussionmentioning

confidence: 99%

Bacteremia in cirrhotic patients submitted to endoscopic band ligation of esophageal varices

Maulaz

Mattos

Pereira-Lima

et al. 2003

Arq. Gastroenterol.

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-Background -Endoscopic procedures can develop bacteremia. Patients with chronic liver disease are more predisposed to undergo bacteremia and infections because they are immunocompromised. Aims -The purpose of this study was to determine the incidence of bacteremia in cirrhotics submitted to endoscopic variceal ligation. Methods -Three groups of 40 patients each were studied. One group was made up of patients with cirrhosis who were submitted to ligation, a second group was composed of cirrhotics who underwent esophagogastroduodenoscopy only, and a third group was composed of patients without liver disease who underwent esophagogastroduodenoscopy. Blood was sampled from all patients for culture, both in aerobic and in anaerobic mediums, immediately before endoscopy and at 5 and 30 minutes after its completion. Results -Blood culture was positive in 6 samples. In 4 of these, the bacteria (Staphylococcus hominis hominis, Staphylococcus auricularis, Acinetobacter lwoffii, and coagulase-negative staphylococcus) were isolated before the endoscopic procedure and thus were considered as contamination. In the ligation group, a streptococcus of the viridans group was isolated 5 minutes after the procedure, and in the cirrhosis without ligation group, a Staphylococcus epidermidis was isolated at 30 minutes. None of the patients showed clinical evidence of infection. Conclusions -The bacteremia incidence in cirrhotic patients submitted to variceal ligation was 2.5%, showing no difference from the control groups.

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“…Brayko ct al. [82] reported an unusually high incidence of Pseudomonas bacteremia sec ondary to a contaminated water bottle. Lange et al [83] have shown that steriliza tion of the endoscope does not affect the pro cedure-related sepsis rate.…”

Section: Complications Of Injection Sclerotherapymentioning

confidence: 99%