Korean J Gastroenterol.  2007 Apr;49(4):225-230.

Contribution of Nasal Methicillin-resistant Staphylococcus aureus Colonization to Percutaneous Endoscopic Gastrostomy Site Infection and Risk Factors of Wound Infection

• Oh HJ
• Shim KN
• Choi HJ
• Lee JS
• Song HJ
• Ryu KH
• Kim TH
• Jung SA
• Yoo K

Abstract

BACKGROUND/AIMS
Peristomal infection is the most common complication of percutaneous endoscopic gastrostomy (PEG) insertion. Methicillin-resistant Staphylococcus aureus (MRSA) is the most commonly implicated organism of peristomal infection. The aims of this study were to determine the contribution of nasal MRSA to wound infection in PEG and the predictors of wound infection.
METHODS
A prospective study was conducted on patients undergoing PEG between September 2003 and July 2005. All patients received antibiotics prior to PEG insertion. Nasal swabs were taken from a consecutive series of patients prior to PEG insertion. Wound status of the peristomal site were prospectively evaluated at day 1, 3, and 7 following the insertion of PEG.
RESULTS
Thirty-one patients underwent PEG insertion (mean age, 66+/-16 years). Ten patients (32.3%) had MRSA-positive nasal swabs. Peristomal infection did not have any relationship with nasal MRSA colonization (p>0.05). Peristomal infection occurred in 4 (12.9%) cases. The rate of peristomal infections was significantly higher in patients with diabetes mellitus (p<0.05).
CONCLUSIONS
Nasal MRSA colonization is not associated with the risk of peristomal infections in patients receiving antibiotics prior to PEG insertion. Diabetes mellitus might be the risk factor for peristomal infection after PEG insertion.

Keyword

Percutaneous endoscopic gastrostomy; Peristomal infection; Colonization; Methicillin-resistant Staphylococcus aureus

MeSH Terms

Aged
Aged, 80 and over
Anti-Bacterial Agents/pharmacology
Diabetes Complications/epidemiology
Female
Gastroscopy
*Gastrostomy
Humans
Male
Methicillin/pharmacology
*Methicillin Resistance
Middle Aged
Nose/microbiology
Risk Factors
Staphylococcal Infections/epidemiology/etiology/*microbiology
Staphylococcus aureus/drug effects/*isolation & purification
Surgical Wound Infection/epidemiology/etiology/*microbiology