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Heath V, Cloutman-Green E, Watkin S, Karlikowska M, Ready D, Hatcher J, Pearce-Smith N, Brown C, Demirjian A. Staphylococcus capitis: Review of Its Role in Infections and Outbreaks. Antibiotics (Basel) 2023; 12:antibiotics12040669. [PMID: 37107031 PMCID: PMC10135222 DOI: 10.3390/antibiotics12040669] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023] Open
Abstract
In June 2021, a national incident team was formed due to an increased detection of Staphylococcus capitis in samples from hospitalised infants. Staphylococcus capitis has been known to cause outbreaks in neonatal units across the globe, but the extent of the UK spread was unclear. A literature review was undertaken to support case identification, clinical management and environmental infection control. A literature search was undertaken on multiple databases from inception to 24 May 2021, using keywords such as “Staphylococcus capitis”, “NRCS-A”, “S. capitis”, “neonate”, “newborn” and “neonatal intensive care unit” (NICU). After screening, 223 articles of relevance were included. Results show incidences of S. capitis outbreaks have frequently been associated with the outbreak clone (NRCS-A) and environmental sources. The NRCS-A harbours a multidrug resistance profile that includes resistance to beta-lactam antibiotics and aminoglycosides, with several papers noting resistance or heteroresistance to vancomycin. The NRCS-A clone also harbours a novel SCCmec-SCCcad/ars/cop composite island and increased vancomycin resistance. The S. capitis NRCS-A clone has been detected for decades, but the reasons for the potentially increased frequency are unclear, as are the most effective interventions to manage outbreaks associated with this clone. This supports the need for improvements in environmental control and decontamination strategies to prevent transmission.
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Thornhill MH, Crum A, Campbell R, Stone T, Lee EC, Bradburn M, Fibisan V, Dayer M, Prendergast BD, Lockhart P, Baddour L, Nicoll J. Temporal association between invasive procedures and infective endocarditis. Heart 2023; 109:223-231. [PMID: 36137742 PMCID: PMC9872236 DOI: 10.1136/heartjnl-2022-321519] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/02/2022] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE Antibiotic prophylaxis has been recommended for patients at increased risk of infective endocarditis (IE) undergoing specific invasive procedures (IPs) despite a lack of data supporting its use. Therefore, antibiotic prophylaxis recommendations ceased in the mid-2000s for all but those at high IE risk undergoing invasive dental procedures. We aimed to quantify any association between IPs and IE. METHODS All 14 731 IE hospital admissions in England between April 2010 and March 2016 were identified from national admissions data, and medical records were searched for IP performed during the 15-month period before IE admission. We compared the incidence of IP during the 3 months immediately before IE admission (case period) with the incidence during the preceding 12 months (control period) to determine whether the odds of developing IE were increased in the 3 months after certain IP. RESULTS The odds of IE were increased following permanent pacemaker and defibrillator implantation (OR 1.54, 95% CI 1.27 to 1.85, p<0.001), extractions/surgical tooth removal (OR 2.14, 95% CI 1.22 to 3.76, p=0.047), upper (OR 1.58, 95% CI 1.34 to 1.85, p<0.001) and lower gastrointestinal endoscopy (OR 1.66, 95% CI 1.35 to 2.04, p<0.001) and bone marrow biopsy (OR 1.76, 95% CI 1.16 to 2.69, p=0.039). Using an alternative analysis, bronchoscopy (OR 1.33, 95% CI 1.06 to 1.68, p=0.049) and blood transfusions/red cell/plasma exchange (OR 1.2, 95% CI 1.07 to 1.35, p=0.012) were also associated with IE. CONCLUSIONS This study identifies a significant association between specific IPs (permanent pacemaker and defibrillator implantation, dental extraction, gastrointestinal endoscopy and bronchoscopy) and subsequent IE that warrants re-evaluation of current antibiotic prophylaxis recommendations to prevent IE in high IE risk individuals.
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Affiliation(s)
- Martin H Thornhill
- Department of Oral & Maxillofacial Medicine, Surgery and Pathology, The University of Sheffield School of Clinical Dentistry, Sheffield, UK .,Department of Oral Medicine/Oral & Maxillofacial Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA
| | - Annabel Crum
- The University of Sheffield School of Health and Related Research, Sheffield, UK
| | - Richard Campbell
- The University of Sheffield School of Health and Related Research, Sheffield, UK
| | - Tony Stone
- The University of Sheffield School of Health and Related Research, Sheffield, UK
| | - Ellen C Lee
- The University of Sheffield School of Health and Related Research, Sheffield, UK
| | - Mike Bradburn
- CTRU, University of Sheffield School of Health and Related Research, Sheffield, UK
| | - Veronica Fibisan
- The University of Sheffield School of Health and Related Research, Sheffield, UK
| | - Mark Dayer
- Department of Cardiology, Somerset Foundation Trust, Taunton, Somerset, UK
| | | | - Peter Lockhart
- Department of Oral Medicine/Oral & Maxillofacial Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA
| | - Larry Baddour
- Departments of Medicine and Cardiovascular Disease, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Jon Nicoll
- The University of Sheffield School of Health and Related Research, Sheffield, UK
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Shatla IM, Banno F, Ejaz A, Lopez Candales A. Recurrent Staphylococcus capitis Prosthetic Valve Endocarditis Presenting With ST-Segment Elevation Myocardial Infarction: A Case Report. Cureus 2022; 14:e22732. [PMID: 35386477 PMCID: PMC8968925 DOI: 10.7759/cureus.22732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 11/25/2022] Open
Abstract
We report a case of ST-elevation myocardial infarction (STEMI) due to septic emboli secondary to Staphylococcus capitis endocarditis in a 32-year-old male patient with a past medical history of infectious endocarditis requiring mechanical aortic, mitral and tricuspid valve replacement presented with sharp chest pain and shortness of breath. Electrocardiogram demonstrated an acute inferior STEMI. Coronary angiography revealed occlusion of the terminal left anterior descending (LAD) artery associated with a large apical wrap-around segment exhibiting TIMI 0 flow. Primary angioplasty was not performed given the distal location of the embolus. Clinical suspicion for septic or thrombotic coronary artery embolism was high given the patient’s history of mechanical valve prosthesis and in the setting of sub-therapeutic INR. Transesophageal echocardiography revealed a new mobile echodensity on the mitral prosthesis consistent with vegetation. S. capitis was isolated from blood cultures, confirming the diagnosis of endocarditis. S. capitis is a rare cause of prosthetic valve endocarditis and should remain in the differential of septic coronary artery embolism among patients with features of infectious endocarditis.
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Thakker RA, Chatila K, Reynoso D, Karnath B. Native and Prosthetic Valve Staphylococcus capitis Endocarditis: A Review of the Literature. Cardiol Res 2021; 12:140-145. [PMID: 34046106 PMCID: PMC8139748 DOI: 10.14740/cr1231] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/13/2021] [Indexed: 11/20/2022] Open
Abstract
Infective endocarditis (IE) is a rare but serious disease. Coagulase-negative staphylococci (CoNS) are among the least prevalent causes of IE. Staphylococcus capitis, a species of CoNS, although described in the literature before has only been seen in a few cases. Even with such few cases, complications and mortality have still been demonstrated. In our review, we look at the epidemiology, diagnosis, management, and literature prevalence of CoNS in native and prosthetic valve IE.
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Affiliation(s)
- Ravi A Thakker
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Khaled Chatila
- Division of Cardiology, University of Texas Medical Branch, Galveston, TX, USA
| | - David Reynoso
- Division of Infectious Disease, University of Texas Medical Branch, Galveston, TX, USA
| | - Bernard Karnath
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
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Tchana-Sato V, Hans G, Frippiat F, Zekhnini I, Dulgheru R, Lavigne JP, Defraigne JO. Surgical management of Staphylococcus capitis prosthetic valve infective endocarditis: Retrospective review of a 10-year single center experience and review of the literature. J Infect Public Health 2020; 13:1705-1709. [DOI: 10.1016/j.jiph.2020.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/21/2020] [Accepted: 09/18/2020] [Indexed: 12/17/2022] Open
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Staphylococcus capitis causing infective endocarditis: not so uncommon. Infection 2020; 48:975-977. [PMID: 32974875 DOI: 10.1007/s15010-020-01514-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022]
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Grossman R, Francis R. The Way to Man's Heart Is through the Stomach. Thorac Cardiovasc Surg 2019; 69:2-7. [PMID: 31756748 DOI: 10.1055/s-0039-1700886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Organ systems do not exist in a vacuum. However, in an era of increasingly specialized medicine, the focus is often on the organ system alone. Many symptoms are associated with differential diagnoses from upper gastrointestinal (GI) and cardiovascular medical and surgical specialties. Furthermore, a large number of rare but deadly conditions cross paths between the upper GI tract and cardiovascular system; a significant proportion of these are iatrogenic injuries from a parallel specialty. These include unusual fistulae, herniae, and embolisms that transcend specialties. This review highlights these conditions and the shared anatomy and embryology of the two organ systems.
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Affiliation(s)
- Rebecca Grossman
- Department of General Surgery, Buckinghamshire Healthcare NHS Trust, Amersham, United Kingdom
| | - Rohin Francis
- The Hatter Cardiovascular Institute, University College London Hospitals NHS Foundation Trust, London, United Kingdom
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Al Hennawi HET, Mahdi EM, Memish ZA. Native valve Staphylococcus capitis infective endocarditis: a mini review. Infection 2019; 48:3-5. [PMID: 31079347 DOI: 10.1007/s15010-019-01311-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 04/26/2019] [Indexed: 12/26/2022]
Abstract
PURPOSE Even though prosthetic valve endocarditis due to coagulase-negative staphylococci (CoNS) is widely documented and attracts global attention, native valve endocarditis due to CoNS has been also described lately and may warrant closer attention due to the relative increased incidence. METHODS We describe a 35-year-old male patient who is a former resident of a long-term health-care facility with multiple co-morbidities, diagnosed with native aortic valve S. capitis endocarditis and underwent conservative antimicrobial treatment with full recovery and no recurrence after 6 months' follow-up. In addition, we reviewed the English literature on all reported cases of S. capitis endocarditis. RESULTS Infective endocarditis due to S. capitis has thus far been described in 13 patients. All but three had involved native valves with two infected prosthetic valves and a single case of infection in an implanted transvenous pacemaker. Although the number of cases of endocarditis due to S. capitis is small, early removal of either a prosthetic valve or infected pacemaker would appear prudent, while native valve endocarditis could successfully be treated with appropriate antimicrobials alone. CONCLUSIONS Staphylococcus capitis is classified as coagulase-negative staphylococci with the inherent ability to cause debilitating native valve endocarditis and is usually managed conservatively.
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Affiliation(s)
| | - Elham Mohammed Mahdi
- Infectious Diseases Division, Department of Medicine, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia
| | - Ziad A Memish
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
- Infectious Diseases Division, Department of Medicine and Department of Research, Prince Mohamed Bin Abdulaziz Hospital, Ministry of Health, P.O. Box 54146, Riyadh, 11514, Saudi Arabia.
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Aaron JG, Sobieszczyk ME, Weiner SD, Whittier S, Lowy FD. Lactobacillus rhamnosus Endocarditis After Upper Endoscopy. Open Forum Infect Dis 2017; 4:ofx085. [PMID: 28695143 PMCID: PMC5499731 DOI: 10.1093/ofid/ofx085] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Accepted: 04/20/2017] [Indexed: 01/20/2023] Open
Abstract
Lactobacillus rhamnosus is commonly found in gastrointestinal flora and used in probiotics but is a rare human pathogen. We report a case of L. rhamnosus endocarditis following upper endoscopy in a frequent consumer of yogurt containing the organism, who required aortic and mitral valve replacement for cure.
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Affiliation(s)
| | | | | | - Susan Whittier
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York
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De Vry DJ, Barker PH, Vardanyan M, Milosavljevic SL, Dygert TN, Jurva JW, Wyler Van Ballmoos MC, Gandhi SD, Hossein Almassi G, Pagel PS. Pneumonia and Inflammatory Arthritis Caused by Unusual Occupational Exposure or a Life-Threatening Infection Resulting From a More Commonly Encountered Mechanism? J Cardiothorac Vasc Anesth 2015; 29:1096-9. [PMID: 25976604 DOI: 10.1053/j.jvca.2015.01.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Indexed: 11/11/2022]
Affiliation(s)
| | - Paul H Barker
- Cardiothoracic Surgery Services, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI
| | | | | | | | | | | | | | - G Hossein Almassi
- Cardiothoracic Surgery Services, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI
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Transmission of infection by flexible gastrointestinal endoscopy and bronchoscopy. Clin Microbiol Rev 2013; 26:231-54. [PMID: 23554415 DOI: 10.1128/cmr.00085-12] [Citation(s) in RCA: 306] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Flexible endoscopy is a widely used diagnostic and therapeutic procedure. Contaminated endoscopes are the medical devices frequently associated with outbreaks of health care-associated infections. Accurate reprocessing of flexible endoscopes involves cleaning and high-level disinfection followed by rinsing and drying before storage. Most contemporary flexible endoscopes cannot be heat sterilized and are designed with multiple channels, which are difficult to clean and disinfect. The ability of bacteria to form biofilms on the inner channel surfaces can contribute to failure of the decontamination process. Implementation of microbiological surveillance of endoscope reprocessing is appropriate to detect early colonization and biofilm formation in the endoscope and to prevent contamination and infection in patients after endoscopic procedures. This review presents an overview of the infections and cross-contaminations related to flexible gastrointestinal endoscopy and bronchoscopy and illustrates the impact of biofilm on endoscope reprocessing and postendoscopic infection.
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Boudabbous M, Amouri A, Mnif L, Tahri N. [Gastrointestinal endoscopy and infection]. Presse Med 2010; 39:887-94. [PMID: 20430569 DOI: 10.1016/j.lpm.2010.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2009] [Revised: 02/25/2010] [Accepted: 03/10/2010] [Indexed: 11/16/2022] Open
Abstract
During a gastrointestinal endoscopy, the device crosses natural cavities with always commensal bacterial flora, sometimes pathogenic flora. In all cases, the device is contaminated after the exam. The lack of effective disinfection exposes to the risks of transmission of germs. The infectious risk depends on the patient, the endoscopic procedure as well as on the technique of disinfection. The bacteraemia is usually not clinically significant. The endoscopic transmission of the germs from a patient to another one is very rare and is mostly due to a defect of disinfection. The procedures for disinfecting equipment should be known, established and controlled.
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Affiliation(s)
- Mona Boudabbous
- EPS Hédi Chaker, service de gastroentérologie, Sfax, Tunisie.
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13
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Shaukat A, Nelson DB. Risks of Infection from Gastrointestinal Endoscopy. TECHNIQUES IN GASTROINTESTINAL ENDOSCOPY 2007. [DOI: 10.1016/j.tgie.2007.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cone LA, Sontz EM, Wilson JW, Mitruka SN. Staphylococcus capitis endocarditis due to a transvenous endocardial pacemaker infection: case report and review of Staphylococcus capitis endocarditis. Int J Infect Dis 2005; 9:335-9. [PMID: 16085441 DOI: 10.1016/j.ijid.2004.08.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2004] [Revised: 07/19/2004] [Accepted: 08/28/2004] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Newer microbiologic methods to determine the species of coagulase-negative staphylococci (CoNS) have evolved which have shown that most endocarditis due to CoNS is caused by Staphylococcus epidermidis, and far fewer by Staphylococcus warneri and Staphylococcus lugdunensis. METHODS The recent opportunity to successfully treat a patient with methicillin-resistant Staphylococcus capitis endocarditis secondary to an infected transvenous pacemaker led to a review of the literature relating to S. capitis endocarditis. RESULTS Thirteen previously recorded patients were identified. Twelve (86%) patients were male. Ten had endocarditis associated with a native valve, two with prosthetic valves and one with a transvenous pacemaker. Mortality was low in all 14 cases (including this case report) with only two deaths; one in a patient with a native valve and the other with a prosthetic valve. Four of the isolates were methicillin resistant but sensitive to vancomycin, which was used in the treatment of eight patients. Those patients with prosthetic cardiac devices appear to do better when the devices are surgically removed. CONCLUSIONS CoNS as a cause of endocarditis appears to be increasing and the current ability to determine the species of these organisms should elicit the epidemiology, clinical characteristics and biomolecular mechanisms involved in the induction of valvular disease.
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Affiliation(s)
- Lawrence A Cone
- Department of Medicine, Section of Infectious Diseases, Eisenhower Medical Center, Rancho Mirage, CA 92270, USA.
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Hirota WK, Petersen K, Baron TH, Goldstein JL, Jacobson BC, Leighton JA, Mallery JS, Waring JP, Fanelli RD, Wheeler-Harbough J, Faigel DO. Guidelines for antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc 2003; 58:475-82. [PMID: 14520276 DOI: 10.1067/s0016-5107(03)01883-2] [Citation(s) in RCA: 172] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This is one of a series of statements discussing the utilization of GI endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text. In preparing this guideline, a MEDLINE literature search was performed, and additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. When little or no data exist from well-designed prospective trials, emphasis is given to results from large series and reports from recognized experts. Guidelines for appropriate utilization of endoscopy are based on a critical review of the available data and expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data appear. Clinical consideration may justify a course of action at variance to these recommendations.
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Affiliation(s)
- Douglas B Nelson
- Gastroenterology, Minneapolis VA Medical Center, Minnesota 55417, USA
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Nelson DB. Infection control during gastrointestinal endoscopy. THE JOURNAL OF LABORATORY AND CLINICAL MEDICINE 2003; 141:159-67. [PMID: 12624597 DOI: 10.1067/mlc.2003.24] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Infection-control issues during gastrointestinal endoscopy, which are becoming increasingly important, can generally be divided into three major areas: (1) infectious complications resulting from a patient's own microbial flora (autologous), (2) infections transmitted from patient to patient by way of the endoscope (exogenous), and (3) infections transmitted between the patient and the health-care provider. The mean frequency of postprocedure bacteremia ranges from 0.5% for flexible sigmoidoscopy to 2.2% for colonoscopy, 4.2% for esophagogastroduodenoscopy, 8.9% for variceal ligation, 11% for endoscopic retrograde cholangiopancreatography, 15.4% for variceal sclerotherapy, and 22.8% for esophageal dilation. Although postprocedure bacteremia is not uncommon, it seldom results in infectious complications. Exogenous infections transmitted during endoscopy, which are extremely rare, generally result from failure to follow accepted guidelines for the cleaning and disinfection of gastrointestinal endoscopes, underscoring the importance of meticulous attention to endoscope reprocessing. Finally, although the risk of patient-staff transmission of infection is also rare, standard infection-control recommendations are important in protecting both patients and health-care providers.
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Affiliation(s)
- Douglas B Nelson
- Department of Gastroenterology, Minneapolis Veterans Affairs Medical Center, University of Minnesota, 55417, USA.
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Montalto M, La Regina M, Gemelli P, Manna R, Gasbarrini G. Mitral valve endocarditis caused by Streptococcus oralis occurring after upper gastrointestinal endoscopy. Am J Gastroenterol 2002; 97:2149-50. [PMID: 12190201 DOI: 10.1111/j.1572-0241.2002.05945.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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