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Clostridium difficile-associated enteric disease after percutaneous endoscopic gastrostomy
Shiro Yokohama1, Masaru Aoshima, Toshiyuki Asama
1Department of Gastroenterology, Asahikawa Rehabilitation Hospital, 1-1 Midorigaoka Higashi, Asahikawa 078-8801, Japan.
Journal of Gastroenterology
|February 14, 2009
Summary
Clostridium difficile-associated enteric disease (CDED) occurred in 6.4% of patients after percutaneous endoscopic gastrostomy (PEG). A history of CDED and longer antibiotic use before PEG were identified as key risk factors for developing this complication.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Medical Devices
Background:
- Percutaneous endoscopic gastrostomy (PEG) is a standard enteral nutrition method.
- Adverse events of PEG are known, but Clostridium difficile-associated enteric disease (CDED) post-PEG is infrequently reported.
- Several cases of early-onset CDED after PEG prompted this investigation.
Purpose of the Study:
- To examine cases of CDED with early onset after PEG.
- To identify potential risk factors associated with CDED development post-PEG.
Main Methods:
- A retrospective analysis of 233 patients who underwent PEG from 1999 onwards.
- CDED was defined as symptom onset within one month of PEG placement.
- Logistic regression analysis was used to evaluate 19 potential predictors for CDED.
Main Results:
- 15 patients (6.4%) developed CDED soon after PEG.
- Most patients recovered with vancomycin, but two experienced significant deterioration.
- Past history of CDED and the duration of antibiotic dosing prior to PEG were significant risk factors.
Conclusions:
- CDED occurs at a notable rate following PEG procedures.
- A history of CDED and prolonged antibiotic administration before PEG are identified as risk factors for post-PEG CDED.
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