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• W2084565369 abstract "The incidence of bacteremia after endoscopic ultrasonography (EUS) or EUS-guided fine-needle aspiration (EUS-FNA) is between 0% and 4%, but there are no data on this topic in cirrhotic patients.To prospectively assess the incidence of bacteremia in cirrhotic patients undergoing EUS and EUS-FNA.We enrolled 41 cirrhotic patients. Of these, 16 (39%) also underwent EUS-FNA. Blood cultures were obtained before and at 5 and 30 min after the procedure. When EUS-FNA was used, an extra blood culture was obtained after the conclusion of radial EUS and before the introduction of the sectorial echoendoscope. All patients were clinically followed up for 7 days for signs of infection.Blood cultures were positive in 16 patients. In 10 patients, blood cultures grew coagulase-negative Staphylococcus, Corynebacterium species, Propionibacterium species or Acinetobacterium Lwoffii, which were considered contaminants (contamination rate 9.8%, 95% CI: 5.7–16%). The remaining 6 patients had true positive blood cultures and were considered to have had true bacteremia (15%, 95% CI: 4–26%). Blood cultures were positive after diagnostic EUS in five patients but were positive after EUS-FNA in only one patient. Thus, the frequency of bacteremia after EUS and EUS-FNA was 12% and 6%, respectively (95% CI: 2–22% and 0.2–30%, respectively). Only one of the patients who developed bacteremia after EUS had a self-limiting fever with no other signs of infection.Asymptomatic Gram-positive bacteremia developed in cirrhotic patients after EUS and EUS-FNA at a rate higher than in non-cirrhotic patients. However, this finding was not associated with any clinically significant infections.La incidencia de bacteriemia después de una ultrasonografía endoscópica (USE) o USE con punción aspirativa con aguja fina (USE-PAAF) se sitúa entre el 0-4%. No existen datos acerca de la incidencia en pacientes con cirrosis hepática.Evaluar prospectivamente la incidencia de bacteriemia en pacientes cirróticos sometidos a USE y USE-PAAF.Se incluyeron un total de 41 pacientes. Dieciséis (39%) fueron sometidos también a USE-PAAF. Se realizaron hemocultivos antes y a los 5 y 30 minutos después del procedimiento. Cuando se practicó USE-PAAF se obtuvo una muestra de sangre adicional después de acabar la USE radial y antes de la introducción del ecoendoscopio sectorial. Todos los pacientes fueron seguidos durante 7 días.Los hemocultivos fueron positivos en 16 pacientes. En 10 pacientes crecieron gérmenes que fueron considerados contaminantes (tasa de contaminación 9,8%, IC 95%: 5,7-16%). Los 6 pacientes restantes tuvieron hemocultivos positivos por gérmenes no contaminantes y fueron considerados verdaderas bacteriemias (15%, IC 95%: 4-26%). En 5 pacientes los hemocultivos fueron positivos después de la USE diagnóstica y solo en uno después de la USE-PAAF. Por lo tanto, la frecuencia de bacteriemia asociada a USE y USE-PAAF fue 12 y 6%, respectivamente (IC 95%: 2-22% y 0,2-30%, respectivamente). Solo uno de los pacientes presentó bacteriemia sintomática tras la USE que consistió en fiebre autolimitada sin otros signos de infección.Los pacientes cirróticos presentan una incidencia de bacteremia asintomática por gérmenes gram-positivos después de la USE (con o sin PAAF) mayor que los pacientes sin esta patología. Sin embargo, este hecho no se asocia a una mayor incidencia de infecciones clínicamente significativas." @default.
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• W2084565369 date "2014-06-01" @default.
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• W2084565369 title "Tuberculosis abdominal diagnosticada endoscópicamente en paciente en tratamiento con fármacos biológicos" @default.
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• W2084565369 doi "https://doi.org/10.1016/j.gastrohep.2013.11.009" @default.
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