TITLE

PERCUTANEOUS ENDOSCOPIC GASTROSTOMY SITES INFECTED BY METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS: IMPACT ON OUTCOME

AUTHOR(S)
Mainie, I.; Loughrey, A.; Watson, J.; Tham, T.C.K.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA11
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Methicillin resistant S aureus infection (MRSA) appears to be associated with an increased incidence of colonisation of percutaneous endoscopic gastrostomy (PEG) sites. Aim: We investigated the impact of prior MRSA colonisation on the incidence of symptomatic PEG site wound infection and mortality. Method: Consecutive patients who had PEG tubes inserted recently were identified and their notes studied retrospectively. Presence or absence of MRSA prior to PEG placement was noted. After PEG placement, patients suspected of having wound infection had swabs taken from the site (no routine swabs taken). Mortality within 30 days of PEG placement was determined. Significant wound infection was defined as those requiring antibiotic treatment. Results: Eighty three patients underwent PEG placement; 23 (28%) of these patients had known MRSA infection prior to PEG placement. Of these, 13 (57%) developed symptomatic MRSA colonisation of the PEG site. The remainder of the patients, 60 (73%), had no known prior MRSA infection. In these patients, 9 (15%) developed symptomatic MRSA colonisation of the PEG site. Thus, there was a significantly higher risk of MRSA infection of the PEG site if patients had prior MRSA infection (p = 0.00013). Only 4 patients with MRSA colonisation of the PEG site required treatment with antibiotics. Thus the incidence of significant wound infection was 5% of total undergoing PEG placement or 18% of those with MRSA colonisation. The mortality (none related to the PEG tube) of those with symptomatic MRSA infection of the PEG site was 9% (2 out of 22), although the mortality from non MRSA infected PEGs was 20% (12 out of 61). There was no significant difference, (p = 0.25). Conclusion: Patients with prior MRSA infection had a significantly higher risk of developing symptomatic MRSA infection of the PEG site. However, there was still a significant risk (15%) for patients with no known prior MRSA infection developing MRSA infection of the...
ACCESSION #
9747322

 

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