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The low incidence of bacteremia after esophageal endoscopic submucosal dissection (ESD) obviates the need for prophylactic antibiotics in esophageal ESD

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Abstract

Background

Although a high incidence of bacteremia after esophageal endoscopic procedures has been reported, the incidence of bacteremia associated with esophageal endoscopic submucosal dissection (ESD) remains unknown. Therefore, we investigated the incidence of bacteremia associated with esophageal ESD.

Methods

From April 2013 to March 2014, patients who underwent esophageal ESD were enrolled prospectively. Two sets of blood cultures were collected from patients at the following time points: (1) immediately after ESD; (2) the next morning; and (3) when fever ≥38 °C was present after ESD.

Results

A total of 424 blood culture sets were collected from 101 patients. Six patients had positive blood cultures immediately after ESD (4 %, 7/202 sets). Another patient had a positive blood culture the next morning (0.5 %, 1/202 sets). Ten patients (10 %) developed a post-ESD fever ≥38 °C, and blood cultures from these patients were all negative (0/20 sets). The seven patients with positive blood cultures had no post-ESD fever or infectious symptoms. Growth of Bacteroides thetaiotaomicron was only observed in one patient (1 %) with positive blood cultures immediately after ESD, and this patient was diagnosed with transient bacteremia. The other six patients were considered to have contaminants in their blood cultures. Thus, the incidence of bacteremia after esophageal ESD was 1 % [95 % confidence interval (CI) 0–5 %]. No patient had infectious symptoms, and none required antibiotics after ESD.

Conclusions

The incidence of bacteremia after esophageal ESD was low and post-ESD fever was not associated with bacteremia. We conclude that use of routine prophylactic antibiotics to patients undergoing esophageal ESD is unnecessary.

Clinical trial registry number

UMIN000012908.

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Authors and Affiliations

  1. Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan

    Noboru Kawata, Masaki Tanaka, Naomi Kakushima, Kohei Takizawa, Kenichiro Imai, Kinichi Hotta, Hiroyuki Matsubayashi & Hiroyuki Ono

  2. Division of Infectious Diseases, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan

    Mika Tsukahara, Ichiro Kawamura & Hanako Kurai

Authors
  1. Noboru Kawata
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  2. Masaki Tanaka
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  3. Naomi Kakushima
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  4. Kohei Takizawa
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  5. Kenichiro Imai
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  6. Kinichi Hotta
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  7. Hiroyuki Matsubayashi
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  9. Ichiro Kawamura
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  11. Hiroyuki Ono
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Corresponding author

Correspondence to Noboru Kawata.

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Disclosure

Noboru Kawata, Masaki Tanaka, Naomi Kakushima, Kohei Takizawa, Kenichiro Imai, Kinichi Hotta, Hiroyuki Matsubayashi, Mika Tsukahara, Ichiro Kawamura, Hanako Kurai, and Hiroyuki Ono have no conflict of interest or financial interests to declare in association with this study.

Additional information

IRB approval The institutional review board of our hospital (T24-50-24-1) and the University Hospital Medical Network Clinical Trial Registry (UMIN000012908) approved this study on April 9, 2013.

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Kawata, N., Tanaka, M., Kakushima, N. et al. The low incidence of bacteremia after esophageal endoscopic submucosal dissection (ESD) obviates the need for prophylactic antibiotics in esophageal ESD. Surg Endosc 30, 5084–5090 (2016). https://doi.org/10.1007/s00464-016-4857-2

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  • DOI: https://doi.org/10.1007/s00464-016-4857-2

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