Prospective Assessment of Peristomal Infections Using Objective Criteria

Manpreet S. Mundi, Sara Seegmiller, Jacob Davidson, Jill Schneckloth, Jessica Saied, Ryan T Hurt

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background: Enteral nutrition (EN) is a safe and cost-effective intervention with significant morbidity and mortality benefit that can also be associated with complications. Peristomal infections can occur in 5%–30% of cases after percutaneous endoscopic gastrostomy placement. Despite this common occurrence, widespread use of objective diagnostic criteria is not prevalent, possibly leading to overuse of antibiotics. Methods: All patients who were reporting symptoms consistent with peristomal infection were evaluated. Criteria based on erythema, induration, and exudates were applied with cumulative score ≥8 indicating peristomal infection. All patients were followed, with additional factors being collected if available. Results: Forty-three patients noted complaints consistent with peristomal infection. In patients with a score <8 (n = 16), only 2 required antibiotics (12.5%) and 1 patient was hospitalized (6.3%). In patients with a score ≥8 (n = 27), 16 had a score of 8 or 9; all patients responded to antibiotics (100%), and 1 was hospitalized (6.3%). In patients with a score ≥10, all (100%) were treated with antibiotics. Five of 11 (45%) patients were hospitalized, with the most common diagnosis being sepsis. Of the baseline variables analyzed, higher body mass index correlated with score ≥10 (26.36 ± 2.94 vs 22.91 ± 4.35 in score <9, P =.0128). Conclusions: Objective criteria were effective in risk stratifying patients who presented with reports of peristomal infection. Patients with a score <8 tended to be at low risk, scores of 8–9 were of moderate risk, and patients with a score ≥10 were at high risk and required very close monitoring or hospitalization.

Original languageEnglish (US)
Pages (from-to)877-884
Number of pages8
JournalJournal of Parenteral and Enteral Nutrition
Volume42
Issue number5
DOIs
StatePublished - Jul 1 2018

Keywords

  • enteral
  • enteral access
  • GI access
  • home nutrition support
  • long-term care

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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