{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T10:26:17Z","timestamp":1775039177062,"version":"3.50.1"},"reference-count":21,"publisher":"FapUNIFESP (SciELO)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Gastroenterol."],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:p>CONTEXT: Healthcare-associated infection represents the most frequent adverse event during care delivery. Medical advances like percutaneous endoscopic gastrostomy have brought improvement on quality of life to patients but an increased risk of healthcare-associated infection. Predictive risk factors for peristomal wound infection are largely unknown but evidence suggests that antibiotic prophylaxis and preventive strategies related to infection control may reduce infection rates. OBJECTIVES: The primary aim was to evaluate the global prevalence rate of peristomal infection. Secondary objectives were to characterise the positive culture results, to evaluate the prophylactic antibiotic protocol and to identify potential risk factors for peristomal infection. METHODS: Retrospective study of 297 patients with percutaneous endoscopic gastrostomy performed at a general hospital between January 2004 and September 2010. Patients received prophylactic cefazolin before the endoscopic gastrostomy procedure. Medical records were reviewed for demographic data, underling disease conditions to percutaneous endoscopic gastrostomy and patient potential intrinsic risk factors. Statistical analysis was made with the statistical program SPSS 17.0. RESULTS: A total of 297 percutaneous endoscopic gastrostomy tubes were inserted. Wound infection occurred in 36 patients (12.1%). Staphylococcus aureus methicillin resistant was the most frequently isolated microorganism (33.3%) followed by Pseudomonas aeruginosa (30.6%). The incidence rate had been rising each year and differ from 4.65% in 2004\/2007 to 17.9% in 2008\/2010. This finding was consistent with the increasing of prevalence global infection rates of the hospital. Most of the infections (55.6%) were detected in the first 10 days post procedure. There was no significant difference in age, body mass index values, mean survival time and duration of percutaneous endoscopic gastrostomy feeding between patients with and without periostomal infection. Institutional factors, namely global prevalence infection rates and the endemic character of Staphylococcus aureus methicillin resistant, play an important role in peristomal infection rates. Traditional antibiotic prophylaxis with cefazolin is not adequate due to the prevalence of resistant organisms. CONCLUSIONS: Peristomal infection is a frequent problem with clinical impact in percutaneous endoscopic gastrostomy patients and should be considered a healthcare associated infection. The antimicrobial prophylaxis regimens using cephalosporins are not adequate and need to be reviewed due to the high prevalence of Staphylococcus aureus methicillin resistant and other resistant organisms in hospitals and nursing homes.<\/jats:p>","DOI":"10.1590\/s0004-28032012000400005","type":"journal-article","created":{"date-parts":[[2013,1,16]],"date-time":"2013-01-16T08:25:56Z","timestamp":1358324756000},"page":"255-258","source":"Crossref","is-referenced-by-count":14,"title":["Peristomal infection after percutaneous endoscopic gastrostomy: a 7-year surveillance of 297 patients"],"prefix":"10.1590","volume":"49","author":[{"given":"Helena","family":"Duarte","sequence":"first","affiliation":[{"name":"Enteral Feeding Team Hospital Garcia de Orta"}]},{"given":"Carla","family":"Santos","sequence":"additional","affiliation":[{"name":"Enteral Feeding Team Hospital Garcia de Orta"}]},{"given":"Manuel Lu\u00eds","family":"Capelas","sequence":"additional","affiliation":[{"name":"Catholic University of Portugal,  Portugal"}]},{"given":"Jorge","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Enteral Feeding Team Hospital Garcia de Orta"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1111\/j.1572-0241.2000.01672.x","article-title":"Sulkes J, Fraser GM, Niv Y: Percutaneous endoscopic gastrostomy: high mortality rates in hospitalized patients","volume":"95","author":"Abuksis G","year":"2000","journal-title":"Am J Gastroenterol","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9270","issn-type":"print"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/j.gie.2008.02.068","article-title":"Antibiotic prophylaxis for GI endoscopy","volume":"67","author":"Banerjee S","year":"2008","journal-title":"Gastrointest Endosc","ISSN":"https:\/\/id.crossref.org\/issn\/0016-5107","issn-type":"print"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"c3115","DOI":"10.1136\/bmj.c3115","article-title":"Novel approach to antibiotic prophylaxis in percutaneous endoscopic gastrostomy (PEG): randomised controlled trial","volume":"341","author":"Blomberg J","year":"2010","journal-title":"BMJ","ISSN":"https:\/\/id.crossref.org\/issn\/0959-8138","issn-type":"print"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1111\/j.1572-0241.2002.05830.x","article-title":"PEG-site infections: the emergence of methicillin resistant Staphylococcus aureus as a major pathogen","volume":"97","author":"Chaudhary KA","year":"2002","journal-title":"Am J Gastroenterol","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9270","issn-type":"print"},{"key":"ref5","series-title":"Antimicrobial resistance surveillance in Europe 2008: Annual report of the European Resistance Surveillance Network (EARS-net)","year":"2009"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1054\/clnu.2001.0533","article-title":"Percutaneous endoscopic gastrostomy and the evolution of contemporary long-term enteral access","volume":"21","author":"Gauderer MW","year":"2002","journal-title":"Clin Nutr","ISSN":"https:\/\/id.crossref.org\/issn\/0261-5614","issn-type":"print"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1111\/j.1572-0241.2006.00366.x","article-title":"Nasopharyngeal decolonization of methicillin-resistant Staphylococcus aureus can reduce PEG peristomal wound infection","volume":"101","author":"Horiuchi A","year":"2006","journal-title":"Am J Gastroenterol","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9270","issn-type":"print"},{"key":"ref8","series-title":"Surveillance of surgical site infections"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1046\/j.1365-2036.2001.01124.x","article-title":"Methicillin-resistant Staphylococcus aureus infections of percutaneous endoscopic gastrostomy sites","volume":"15","author":"Hull M","year":"2001","journal-title":"Aliment Pharmacol Ther","ISSN":"https:\/\/id.crossref.org\/issn\/0269-2813","issn-type":"print"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.jhin.2008.04.021","article-title":"Four country healthcare associated infections prevalence survey 2006: risk factor analysis","volume":"69","author":"Humphreys H","year":"2008","journal-title":"J Hosp Infect","ISSN":"https:\/\/id.crossref.org\/issn\/0195-6701","issn-type":"print"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1093\/cid\/ciq146","article-title":"Clinical practice guidelines by the infectious diseases society of America for the treatment of methicillin-resistant Staphylococcus aureus in adults and children","volume":"52","year":"2011","journal-title":"Clin Infect Dis","ISSN":"https:\/\/id.crossref.org\/issn\/1058-4838","issn-type":"print"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"s4, s6","DOI":"10.12968\/bjon.2009.18.Sup1.39631","article-title":"Peristomal MRSA: a case study","volume":"18","author":"Keely F","year":"2009","journal-title":"Br J Nurs","ISSN":"https:\/\/id.crossref.org\/issn\/0966-0461","issn-type":"print"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/S1590-8658(02)80256-0","article-title":"Increased risk of peristomal wound infection after percutaneous endoscopic gastrostomy in patients with diabetes mellitus","volume":"34","author":"Lee JH","year":"2002","journal-title":"Dig Liver Dis"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.ijid.2007.09.019","article-title":"Clinical impact and risk factors for percutaneous gastrostomy wound infections due to resistant organisms","volume":"12","author":"Mahadeva S","year":"2008","journal-title":"Int J Infect Dis","ISSN":"https:\/\/id.crossref.org\/issn\/1201-9712","issn-type":"print"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1086\/501620","article-title":"Guideline for prevention of surgical site infection","volume":"20","author":"Mangram AJ","year":"1999","journal-title":"Inf Control Hosp Epidemiol"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.jhin.2004.05.015","article-title":"Prevention of percutaneous endoscopic gastrostomy site infection caused by methicillin-resistant Staphylococcus aureus","volume":"58","author":"Rao GG","year":"2004","journal-title":"J Hosp Infect","ISSN":"https:\/\/id.crossref.org\/issn\/0195-6701","issn-type":"print"},{"key":"ref17","first-page":"399","article-title":"Gastrostomia endosc\u00f3pica percut\u00e2nea: 7 a\u00f1os de experiencia en nutrici\u00f3n enteral a largo prazo. Seguimiento cl\u00ednico","volume":"26","author":"Rodr\u00edguez Ortega P","year":"2011","journal-title":"Nutr Hosp","ISSN":"https:\/\/id.crossref.org\/issn\/0212-1611","issn-type":"print"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"3133","DOI":"10.1111\/j.1572-0241.2000.03283.x","article-title":"Meta-analysis of randomised, controlled trials of antibiotic prophylaxis before percutaneous endoscopic gastrostomy","volume":"95","author":"Sharma VK","year":"2000","journal-title":"Am J Gastroenterol","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9270","issn-type":"print"},{"key":"ref19","series-title":"Management of multidrug-resistant organisms in healthcare settings, 2006","author":"Siegel JD","year":"2006"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1111\/j.1365-2036.2006.03242.x","article-title":"The role of screening and antibiotic prophylaxis in the prevention of percutaneous gastrostomy site infection caused by methicillin-resistant Staphylococcus aureus","volume":"25","author":"Thomas S","year":"2007","journal-title":"Aliment Pharmacol Ther","ISSN":"https:\/\/id.crossref.org\/issn\/0269-2813","issn-type":"print"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1155\/2008\/530109","article-title":"Local infection after placement of percutaneous endoscopic gastrostomy tubes: a prospective study evaluating risk factors","volume":"22","author":"Zopf Y","year":"2008","journal-title":"Can J Gastroenterol","ISSN":"https:\/\/id.crossref.org\/issn\/0835-7900","issn-type":"print"}],"container-title":["Arquivos de Gastroenterologia"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/ag\/v49n4\/05.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,5,27]],"date-time":"2017-05-27T15:49:23Z","timestamp":1495900163000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0004-28032012000400005&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,12]]},"references-count":21,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2012,12]]}},"alternative-id":["S0004-28032012000400005"],"URL":"https:\/\/doi.org\/10.1590\/s0004-28032012000400005","relation":{},"ISSN":["0004-2803"],"issn-type":[{"value":"0004-2803","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,12]]}}}