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Percutaneous endoscopic gastrostomy site infections-Incidence and risk factors

Kayal Vizhi1, Harshavardhan B Rao2, Rama P Venu1

  • 1Department of Gastroenterology, Amrita Institute of Medical Sciences, Ponekkara, Kochi, 682 041, India.

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
|February 24, 2018
PubMed

Insights

Peristomal infection (PI) affects 21.9% of patients after percutaneous endoscopic gastrostomy (PEG) placement. Diabetes, long hospital stays, and hypoalbuminemia are key risk factors, with Pseudomonas and Klebsiella being common pathogens.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Surgical Complications

Background:

  • Percutaneous endoscopic gastrostomy (PEG) is a preferred method for long-term enteral nutrition due to its ease and cost-effectiveness.
  • Peristomal infection (PI) is the most frequent complication following PEG tube insertion.
  • Understanding PI incidence, risk factors, and microbiology is crucial for effective prevention and treatment strategies.

Purpose of the Study:

  • To determine the incidence and identify risk factors associated with peristomal infection (PI) after percutaneous endoscopic gastrostomy (PEG) placement.
  • To establish the microbiological profile of PI to guide prophylactic and therapeutic antibiotic choices.
  • To provide evidence-based recommendations for minimizing PI in patients undergoing PEG procedures.

Main Methods:

  • A retrospective analysis of 781 patients who underwent PEG placement between 2010 and 2015 at a tertiary care center.
  • Data collection from electronic medical records, including patient demographics, indications for PEG, and outcomes.
  • Univariate analysis was used to assess risk factors for PI, and microbiological data from culture reports were analyzed.

Main Results:

  • The incidence of peristomal infection (PI) was 21.9% (171 out of 781 patients).
  • Significant risk factors for PI included diabetes mellitus, hospital stays exceeding 7 days, and hypoalbuminemia (p < 0.05).
  • Patients receiving chemotherapy or radiotherapy prior to PEG placement had a higher incidence of PI (p = 0.00), with Pseudomonas and Klebsiella being the most common causative organisms.

Conclusions:

  • Peristomal infection (PI) is a significant complication of percutaneous endoscopic gastrostomy (PEG) placement.
  • Prophylactic antibiotic strategies should be tailored to target common pathogens like Pseudomonas and Klebsiella.
  • Elective PEG placement before chemotherapy or radiotherapy is recommended for patients with oropharyngeal malignancies to reduce PI risk.
Abstract

Keywords:
ComplicationsEndoscopicEnteralGastrostomyInfectionsNutritionPercutaneous endoscopic gastrostomy

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