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Incidence of infectious complications after an ultrasound-guided intervention
Patrick Cervini1, Gina K Hesley, Rodney L Thompson
1Department of Radiology, Hotel-Dieu Grace Hospital, Windsor, ON, Canada.
Objective:
The objective of our study was to determine the incidence of infectious complications of common ultrasound-guided procedures including fine-needle aspiration (FNA), drain placement, biopsy, pseudoaneurysm thrombin injection, thoracentesis, and paracentesis.
Subjects And Methods:
The infection prevention and control (IPAC) committee at the Mayo Clinic, Rochester, MN, conducts surveillance of selected infections including radiology procedures. When a positive culture, hospital admission, or operating room visit for infection is identified, the patient's electronic records are thoroughly reviewed by an infection control practitioner looking for information about prior interventions. Similarly, the department of radiology prospectively follows all patients who have undergone ultrasound-guided hepatic, renal, and pancreatic biopsies for complications 24 hours, 3 months, and 12 months after biopsy. We reviewed 2 years of these data to determine the incidence of infections after common ultrasound-guided procedures.
Results:
We performed 13,534 ultrasound-guided procedures from January 2006 to December 2007. There were 11 likely and three possible procedure-related infections for an overall incidence of 0.1% (14/13,534). The infections consisted of five abscesses, four bloodstream infections, four cases of peritonitis, and one urinary tract infection. The highest incidence of infections occurred after ultrasound-guided biopsy (0.2%, 10/5,487), with biopsy of a hepatic transplant having the highest incidence (1.0%, 2/192). No infections occurred after thoracentesis and FNA despite the large number of procedures performed (2,489 and 2,340, respectively). Nearly all patients improved on antibiotics. One patient died 5 days after paracentesis; however, death was likely due to multiorgan failure in the setting of fulminant liver failure with hepatorenal syndrome.
Conclusion:
The incidence of a serious infectious complication after ultrasoundguided intervention is low. Radiologists can use these data to provide more accurate information to patients when asking for consent before procedures and to reassure their patients.
Insights
Infectious complications from ultrasound-guided procedures are rare, with an overall incidence of 0.1%. Ultrasound-guided biopsy had the highest infection rate, while thoracentesis and fine-needle aspiration (FNA) had none.
Area of Science:
- Radiology
- Infectious Diseases
- Medical Procedures
Background:
- Infection prevention is crucial in interventional radiology.
- Ultrasound-guided procedures are common but carry a risk of complications.
- Data on infectious complication rates for specific ultrasound-guided interventions are limited.
Purpose of the Study:
- To determine the incidence of infectious complications following common ultrasound-guided procedures.
- To identify specific procedures with higher or lower risks of infection.
- To provide data for informed patient consent and procedural reassurance.
Main Methods:
- Retrospective review of 13,534 ultrasound-guided procedures performed between January 2006 and December 2007.
- Surveillance by the infection prevention and control committee and prospective follow-up by the radiology department.
- Inclusion of procedures such as fine-needle aspiration (FNA), drain placement, biopsy, pseudoaneurysm thrombin injection, thoracentesis, and paracentesis.
Main Results:
- An overall incidence of 0.1% (14/13,534) procedure-related infections was observed.
- Infections included abscesses, bloodstream infections, peritonitis, and urinary tract infections.
- Ultrasound-guided biopsy showed the highest infection rate (0.2%), particularly hepatic transplant biopsies (1.0%). No infections were seen with thoracentesis or FNA.
Conclusions:
- Serious infectious complications after ultrasound-guided interventions are infrequent.
- These findings support accurate patient counseling regarding procedural risks.
- The low incidence reassures patients undergoing these common radiological procedures.
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