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Does bacteremia follow upper gastrointestinal endoscopy?

R G Norfleet, P D Mitchell, D D Mulholland

The American Journal of Gastroenterology

|November 1, 1981

Summary

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This study found a low risk of bacteremia (blood infection) after upper gastrointestinal endoscopy. Prophylactic antibiotics are recommended only for patients with prosthetic heart valves.

Area of Science:

Gastroenterology
Infectious Diseases
Medical Microbiology

Background:

Bacteremia, a bloodstream infection, can be a risk following invasive medical procedures.
Upper gastrointestinal endoscopy is a common diagnostic and therapeutic procedure.

Purpose of the Study:

To assess the incidence and risk factors of bacteremia following fiberoptic endoscopy of the upper digestive tract.
To evaluate the necessity of prophylactic antibiotics in patients undergoing upper gastrointestinal endoscopy.

Main Methods:

Blood cultures were collected from 53 patients before and at 5, 10, and 15 minutes after fiberoptic endoscopy.
A meta-analysis of this study with four previous studies was conducted, evaluating a total of 447 patients.

Main Results:

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One patient (approximately 2%) in the primary study experienced transient bacteremia with Acinetobacter Sp. five minutes post-endoscopy.
Across five combined studies involving 447 patients, 6% developed bacteremia after upper gastrointestinal endoscopy.
Performing biopsies or other endoscopic operations did not significantly increase the likelihood of bacteremia.

Conclusions:

The risk of bacteremia following upper gastrointestinal endoscopy is low.
Routine prophylactic antibiotics are not generally recommended for all patients undergoing this procedure.
Prophylactic antibiotics, such as penicillin or oxacillin, should be considered primarily for patients with prosthetic heart valves to prevent infective endocarditis.