Abstract
Background
Patients with cirrhosis are at high risk of bacterial infections. Invasive procedures
are generally believed to increase this susceptibility.
Aims
We investigated the incidence of bacterial infections in cirrhotic patients undergoing
elective endoscopic variceal ligation (EVL).
Methods
We enrolled 60 consecutive cirrhotic patients who underwent a total number of 112
elective EVL procedures. One to seven bands were applied at each session until variceal
eradication. Markers of inflammation/infection and blood cultures were obtained before
and 24 h after EVL.
Results
Aetiology of liver disease was metabolic in 27 (45%), viral in 21 (35%), alcoholic
in 12 (20%) patients. Child–Pugh class A/B/C distribution was 29/26/5, respectively,
23 (38%) patients had ascites and 15 (25%) had hepatocellular carcinoma. Blood cultures
were negative in all samples before EVL, whereas 3/112 (2.7%) cultures tested positive
after endoscopy. Streptococcus mitis and Staphylococcus epidermidis were isolated in 1 and 2 cases, respectively. None of these three patients developed
any features of clinically relevant infection, suggesting that the positive cultures
were an expression of a transient bacteraemia with no clinical sequelae.
Conclusions
Bacterial infection is an uncommon occurrence after elective EVL in cirrhotic patients,
and antibiotic prophylaxis is not necessary in this clinical setting.
Keywords
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Article info
Publication history
Published online: December 20, 2017
Accepted:
December 11,
2017
Received in revised form:
November 11,
2017
Received:
August 22,
2017
Identification
Copyright
© 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
