Marsicano L J, Serrano N, Urrestarazu M I, Poleo J R
Servicio de Gastroenterología, Hospital Vargas, Caracas.
G E N. 1990 Jan-Mar;44(1):28-34.
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.
与所有内镜检查一样，内镜逆行胰胆管造影（ERCP）也存在一些并发症风险，其中包括感染。任何内镜检查和胃肠道手术都可能发生菌血症。ERCP的菌血症发生率约为0%至5.6%。在本研究中，我们旨在确定ERCP引起的菌血症发生率、导致菌血症的病原体，并将导管病变、淤滞与菌血症进行关联分析。1988年5月至10月，在加拉加斯的瓦尔加斯医院，对纳入分析的患者进行了22例ERCP操作。在ERCP术前、胆管和/或胰管插管后立即以及检查结束后5分钟采集需氧菌和厌氧菌血培养样本。报告显示菌血症发生率较高，为13.6%，之前所有血培养均为阴性。血培养阳性发生在插管过程中，检查结束后的血培养均为阴性。分离出的病原体是解糖消化球菌和表皮葡萄球菌，二者均为小肠正常菌群，后者也是皮肤正常菌群。导管病变、淤滞与菌血症之间无关联。一些病原体与医院感染病原体有关，尽管我们认为附件和设备的消毒和清洁是充分的。对于有瓣膜假体的免疫抑制患者，建议使用预防性抗生素。
