446. Percutaneous Endoscopic Gastrostomy (PEG) Tube Site Infections in Cancer Patients
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
BACKGROUND: The most common complications of PEG tube placement is infection at the PEG tube site. Peristomal irritation at the site occurs commonly but only few infections require aggressive or surgical management. This retrospective review describes infections after PEG tube infections at the MCC. Because of its location, colonization at the insertion site with enteric flora however is common. When PEG site infections do occur enteric GNB and skin flora such as MRSA predominate.
METHODS: Records of 226 patients who had PEG tubes placed January to December 2008 were reviewed. A PEG tube infection was defined as redness and purulent discharge at the exit site.
RESULTS: 8 (3%) out of 226 cancer patients experienced infections at the insertion site. The time of clinical infection documented after insertion of the PEG tube was a mean of 8 days (range 2-14 days). One patient was not included because infection occurred 2 years after insertion. The most common organisms were gram negatives: Pseudomonas aeruginosa (4), Enterobacter (3), Achromobacter (1), and Methicillin -Resistant Staphylococcus aureus (1). Candida species was isolated in 4 patients. The most common malignancy in infected patients was head and neck cancer (7). No patients received prophylactic treatment. All patients with clinical infections were empirically treated with cephalexin until cultures were finalized. Patients with cultures positive for GNB were given ciprofloxacin, or levofloxacin, or cefepime. Fungal infections were not treated. None of the PEG tubes were removed and the infection resolved with antibiotic therapy alone. No cases of peritonitis or necrotizing fascitis developed.
CONCLUSIONS: PEG site infections are uncommon and easily managed with antibiotic therapy directed toward the organisms cultured at the insertion site. Removal of PEG tubes is usually not required for peristomal site infections.
John Greene, MD1, Sreenath Kodali, MD1, Stacy Martin, RN1, Kathie McDonald, RN1, Kay Sams, RN1 and  S. Kodali, None..
K. McDonald, None..
K. Sams, None..
S. Martin, None..
J. N. Greene, None., (1)H. Lee Moffitt Cancer Center, Tampa, FL