Bacteremia associated with esophageal dilatation.

Area of Science:

• Gastroenterology
• Infectious Disease

Background:

• Previous reports indicated a high incidence of bacteremia following esophageal dilatation.
• This incidence did not align with clinical observations.

Purpose of the Study:

• To investigate the actual incidence of bacteremia after esophageal dilatation.
• To determine if routine sterilization of dilators is sufficient or if extra precautions are needed.

Main Methods:

• 17 adult patients with benign esophageal strictures underwent dilatation on 41 occasions.
• Blood cultures were drawn within 30 minutes post-dilatation.
• Dilators were used either routinely sterilized or re-sterilized before each procedure in a randomized manner.

Main Results:

• No significant temperature or white blood cell count changes were observed.
• Two blood cultures yielded Staphylococcus epidermidis, deemed contaminants.
• No bacteremia was confirmed in any patient regardless of sterilization method.

Conclusions:

• Routine sterilization of dilators is adequate for standard benign esophageal stricture dilatation.
• Extra precautions, including pre-procedure sterilization, are recommended for high-risk patients (e.g., those with cancer, tight strictures, or at risk for endocarditis).