ABSENCE OF BACTEREMIA AFTER GASTROINTESTINAL PROCEDURES IN CHILDREN

Background: Transient bacteremia after certain gastrointestinal endosc opies is well documented in adult patients; however, experience in ped iatric patients is very limited. We conducted a prospective study to d etermine the frequency of bacteremia after common endoscopic procedure s in children. Methods: A total of 108 endoscopies were performed in 9 5 patients (age range 8 months to 17 years; mean age 10.2 years). Proc edures included 68 esophagogastroduodenoscopies (EGDs), 29 colonoscopi es, and 11 flexible sigmoidoscopies. Most procedures (88) were perform ed with patients under conscious sedation; 20 were under general anest hesia with endotracheal intubation. Biopsy specimens were obtained fro m all patients. Blood samples for aerobic and anaerobic cultures were obtained prior to, and within 5 minutes of, completion of the procedur e. In patients who underwent general anesthesia, a third sample was ob tained 5 minutes after endotracheal intubation and before endoscopy. R esults: Four of the pre-endoscopic blood cultures were positive. Two c ultures were positive after endotracheal intubation, but were negative after endoscopy. Four cultures were positive after endoscopy. All org anisms were skin or environmental flora and were considered contaminan ts. All patients with positive cultures remained asymptomatic during t he 72 hours after the procedure. Conclusion: We conclude that clinical ly relevant bacteremia is very infrequent following routine endoscopic procedures with biopsies in immunocompetent children.