经皮内镜下胃造口术（PEG）部位感染：来自印度大学教学医院的一项临床和微生物学研究
Percutaneous endoscopic gastrostomy (PEG) site infections: a clinical and microbiological study from university teaching hospital, India.
作者信息
Krishna Sushma, Singh Sanjeev, Dinesh Kavitha R, Kp Remya, Siyad Ismail, Karim Shamsul
机构信息
Department Of Microbiology, Amrita Institute of Medical Sciences, India. Current temporary address: MPH Scholar Institute of Tropical Medicine, Antwerp, Belgium.
Departments of Infection Control and Medical Administration, Amrita Institute of Medical Sciences, Kochi, India.
出版信息
J Infect Prev. 2015 May;16(3):113-116. doi: 10.1177/1757177414558956. Epub 2014 Dec 10.
BACKGROUND
Percutaneous endoscopic gastrostomy (PEG) is used to provide enteral access in patients who are unable to swallow. Infection of the stoma is an important complication and there is little data from India on this problem, which can be used to inform infection prevention and prophylactic strategies.
AIM
The objective was to assess the prevalence and the role of contributory factors in PEG site infections.
METHODS
A total of 173 patients underwent PEG insertion from January 2011 to May 2012. Clinical and microbiological data were collected for culture-positive cases. Insertion was performed using a standard sterile pull-through technique. Infections were defined as two of: peristomal erythema, induration, and purulent discharge.
RESULTS
A total of 54 PEG infections occurred in 43 patients (28.85%). Seventy-seven organisms were isolated. was the most common (=29) followed by coliforms (=21) and meticillin resistant (MRSA) (=6). Thirty-one (72%) received amoxicillin-clavulanic acid as prophylaxis and 12 (28%) were receiving concomitant antibiotics for their underlying conditions. The occurrence of PEG site infections was statistically independent of the administered prophylactic antibiotics (=0.3).
CONCLUSIONS
This study has demonstrated the importance of PEG sites as a cause of healthcare associated infections. Educating patients on wound care practices would play a significant role in prevention of PEG site infections.
背景
经皮内镜下胃造口术（PEG）用于为无法吞咽的患者提供肠内营养通路。造口感染是一种重要的并发症，而印度关于这一问题的数据很少，这些数据可用于指导感染预防和预防策略。
目的
评估PEG部位感染的患病率及相关因素的作用。
方法
2011年1月至2012年5月，共有173例患者接受了PEG置入术。收集培养阳性病例的临床和微生物学数据。采用标准无菌拉出技术进行置入。感染定义为以下两种情况：造口周围红斑、硬结和脓性分泌物。
结果
43例患者共发生54例PEG感染（28.85%）。分离出77种微生物。最常见的是[未提及具体微生物名称]（=29），其次是大肠菌群（=21）和耐甲氧西林[未提及具体微生物名称]（MRSA）（=6）。31例（72%）接受阿莫西林-克拉维酸预防，12例（28%）因基础疾病同时接受抗生素治疗。PEG部位感染的发生与预防性使用的抗生素在统计学上无关（P=0.3）。
结论
本研究证明了PEG部位作为医疗相关感染源的重要性。对患者进行伤口护理知识教育对预防PEG部位感染将起到重要作用。
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