Risk Factors and Role of Antibiotic Prophylaxis for Wound Infections after Percutaneous Endoscopic Gastrostomy

Author:

Mondorf Antonia1ORCID,Amini Clara1,Graf Christiana1,Michael Florian Alexander1ORCID,Blumenstein Irina1,Jung Michael1,Friedrich-Rust Mireen1,Hack Daniel23,Besier Silke M.23,Hogardt Michael23,Kempf Volkhard A. J.23ORCID,Zeuzem Stefan1,Welsch Christoph1ORCID,Bojunga Jörg1

Affiliation:

1. Department of Internal Medicine 1, Goethe University Hospital Frankfurt, Goethe-University, 60596 Frankfurt am Main, Germany

2. Institute for Medical Microbiology and Infection Control, University Hospital Frankfurt, Goethe-University, 60596 Frankfurt am Main, Germany

3. University Center of Competence for Infection Control of the State of Hesse, 60596 Frankfurt am Main, Germany

Abstract

Background and study aim: The incidence of wound infections after percutaneous endoscopic gastrostomy (PEG) varies widely in recent studies. The present study systematically investigates the underlying risk factors for the development of wound infections in a large cohort of patients over a long-term follow-up period. Patients and Methods: A retrospective cohort study of patients undergoing PEG insertion using either the pull or push technique was conducted and patients followed up for 3 years. Tube-related wound infections were identified, and pathogens regularly cultured from wound swabs. Adjusted analysis was performed via univariate and multivariate logistic regression analysis. Results: 616 patients were included in this study. A total of 25% percent of patients developed wound infections upon PEG tube insertion and 6.5% showed recurrent infections. Nicotine abuse (p = 0.01), previous ischemic stroke (p = 0.01) and head and neck cancer (p < 0.001) showed an increased risk for wound infection after PEG placement. Moreover, radio-chemotherapy was associated with the occurrence of wound infections (p < 0.001). Infection rates were similar between pull and push cohorts. The most common bacterial pathogen detected was Enterobacterales (19.2%). Staphylococcus aureus, Pseudomonas aeruginosa and enterococci were frequently detected in recurrent infection (14.2%, 11.4% and 9.6%, respectively). Antibiotic prophylaxis showed no effect on infection rates. Conclusions: Wound infections after PEG placement are common and occasionally occur as recurrent infections. There is potential for improvement in everyday clinical practice, particularly regarding antibiotic prophylaxis in accordance with guidelines.

Publisher

MDPI AG

Subject

General Medicine

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