Muñoz-Dávila M J, Xandri Ruipera J M, Yagüe Guirao G, Salvador García C, Segovia Hernández M
María José Muñoz-Dávila, Servicio de Microbiología. Hospital Clínico Universitario Virgen de la Arrixaca. Ctra. Madrid-Cartagena, s/n, 30120 El Palmar, Murcia. Spain.
Rev Esp Quimioter. 2017 Oct;30(5):334-340. Epub 2017 Aug 14.
Gastrostomy tube is the best option for long-term enteral nutrition. Among its limitations, infections represent the most frequent minor complication. Our aim is the knowledge of the number and type of gastrostomy tubes and its main indication in our hospital. In addition, prevalence of infectious complications was studied paying attention to the main etiologic agents and their antibiotic susceptibility.
Observational retrospective study from January 2010 to July 2015 through the electronic clinical history and the clinical microbiology laboratory software. Identification and antibiotic susceptibility of clinically significant isolates from patients with suspicion of gastrostomy tube infection have been analysed.
Percutaneous endoscopic gastrostomy was performed in 203 patients (70.5%) and surgical gastrostomy in 85 (29.5%). The main reason identified for starting enteral nutrition through gastrostomy tube was malignant neoplasy, above all, lip, oral cavity and pharynx cancer (11.8%) and that from digestive organs (8.7%). Global prevalence of gastrostomy tube infection was 16.6%. The most common bacterial pathogens isolated were Staphylococcus aureus (21.3%), Pseudomonas aeruginosa (13.1%), and Escherichia coli (9.8%). The percentage of multi resistant isolates was 3.1%.
Gastrostomy tube indications and type, and also, prevalence and microorganisms isolated from culture in infectious complications are similar to those described previously in the literature. The study allows the adaptation of the antibiotic prophylaxis and empirical antibiotic treatment thanks to the knowledge of the etiologic agents and their antibiotic susceptibility.
胃造瘘管是长期肠内营养的最佳选择。在其局限性中，感染是最常见的轻微并发症。我们的目的是了解我院胃造瘘管的数量和类型及其主要适应证。此外，研究了感染性并发症的发生率，关注主要病原体及其抗生素敏感性。
通过电子临床病史和临床微生物学实验室软件，对2010年1月至2015年7月进行回顾性观察研究。分析了疑似胃造瘘管感染患者临床显著分离株的鉴定和抗生素敏感性。
203例患者（70.5%）行内镜下经皮胃造瘘术，85例（29.5%）行外科胃造瘘术。确定通过胃造瘘管开始肠内营养的主要原因是恶性肿瘤，尤其是唇、口腔和咽癌（11.8%）以及消化器官癌（8.7%）。胃造瘘管感染的总体发生率为16.6%。分离出的最常见细菌病原体是金黄色葡萄球菌（21.3%）、铜绿假单胞菌（13.1%）和大肠杆菌（9.8%）。多重耐药分离株的比例为3.1%。
胃造瘘管的适应证和类型，以及感染性并发症中培养分离出的患病率和微生物与文献中先前描述的相似。由于了解病原体及其抗生素敏感性，该研究有助于调整抗生素预防和经验性抗生素治疗。
