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CT colonography and transient bacteraemia: implications for antibiotic prophylaxis
C A Ridge1, M R Carter, L P Browne
1Department of Radiology, St Vincent's University Hospital, Dublin, Ireland. caroleridge@hotmail.com
European Radiology
|August 17, 2010
Summary
Transient bacteraemia after CT colonography (CTC) is low, with no significant cases found in this study. Patients with at-risk cardiac lesions do not require antibiotic prophylaxis before CTC.
Area of Science:
- Medical Imaging
- Microbiology
- Infectious Diseases
Background:
- Guidelines recommend no antibiotic prophylaxis for lower gastrointestinal endoscopy in patients with at-risk cardiac lesions (ARCL) due to low risk of infective endocarditis.
- The risk of transient bacteraemia following CT colonography (CTC) is not well-established.
Purpose of the Study:
- To determine the prevalence of transient bacteraemia after CT colonography (CTC).
- To assess the need for antibiotic prophylaxis in patients with ARCL undergoing CTC.
Main Methods:
- 100 patients undergoing CTC had blood cultures taken at 5, 10, and 15 minutes post-procedure.
- Blood samples were cultured aerobically and anaerobically.
- Positive cultures were analyzed for significant bacteraemia, distinguishing from skin contaminants.
Main Results:
- Sixteen blood cultures showed growth, but all were identified as skin contaminants.
- No cases of significant bacteraemia were detected following CTC.
- The estimated rate of significant bacteraemia from CTC was 0-3.7% (95% CI).
Conclusions:
- The prevalence of transient bacteraemia after CTC is low.
- Current guidelines for lower gastrointestinal endoscopy regarding antibiotic prophylaxis for ARCL patients are supported by these findings.
- Antibiotic prophylaxis is not indicated for patients with ARCL undergoing CTC.
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