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Bacteremia with esophageal dilation

D B Nelson1, S J Sanderson, M M Azar

  • 1Gastroenterology Section, Departments of Medicine and Laboratory Medicine and Pathology, Minneapolis VA Medical Center, University of Minnesota, Minneapolis, MN, USA.

Gastrointestinal Endoscopy
|December 16, 1998
PubMed
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Bacteremia (bacteria in the bloodstream) occurs in 22% of esophageal dilation procedures, particularly with malignant strictures or multiple dilator uses. The source of bacteria is not the dilator itself.

Area of Science:

  • Gastroenterology
  • Infectious Disease

Background:

  • Antibiotic prophylaxis is often recommended for esophageal stricture dilation due to concerns about bacteremia.
  • Previous studies suggested a high rate of bacteremia, necessitating further investigation.

Purpose of the Study:

  • To determine the incidence of bacteremia following esophageal dilation.
  • To identify the source of microorganisms recovered from blood cultures.

Main Methods:

  • Blood cultures and temperature monitoring were performed before and after esophageal dilation.
  • Dilators were cultured to assess for potential contamination.
  • Data on stricture type (benign vs. malignant) and dilation technique were collected.

Main Results:

Related Experiment Videos

  • 22% of 100 esophageal dilation procedures resulted in positive post-dilation blood cultures.
  • Bacteremia was significantly higher in malignant strictures (52.9%) compared to benign strictures (15.7%).
  • Multiple dilator passages were associated with a higher bacteremia rate (34.8%) than single dilator passages (11.1%).

    • Conclusions:

    • The rate of bacteremia after esophageal dilation is 22%.
    • Malignant strictures and the use of multiple dilators are risk factors for bacteremia.
    • The study found no evidence that dilators are the source of bacteremia.