[Retrograde endoscopic cholangiopancreatography. Incidence of bacteremia]

ERCP like all the endoscopic procedures, implies some risks of complications, between them, infections. Bacteremia may occur in any endoscopic and gastrointestinal procedure. The rate on ERCP is about 0 to 5.6%. In the present investigation we intended to determine the rate of bacteremia produced by ERCP, the organism that cause bacteremia and to correlate ductal pathology, stasis and bacteremia. From May to October 1988, at the Hospital Vargas of Caracas, 22 ERCP were performed in patients that were included for analysis. Haemocultives were taken for aerobics and anaerobics, gems before ERCP, immediately after the cannulation of biliary and/or pancreatic ducts and 5 minutes later after concluding the study. A high incidence of bacteremia was reported, 13.6%, all the previous haemocultives were negative. The positive haemocultives were during the cannulation procedure and no haemocultive after the study was positive. The organism isolate were Peptococcus sacharoliticcus and Staphylococcus epidermidis both of the normal flora of small intestine and the last one on the skin too. There were not relation between the ductal pathology, stasis and bacteremia. Some organisms were related to nosocomial agents, we considered though the disinfection and polishment of the accessories and equipment adequate. It is recommendable to use prophylactic antibiotic in immunosuppressed patients with valvular prosthesis.