Incidence of bacteremia in transesophageal echocardiography: a prospective study of 140 consecutive patients

Victoria Hospital, London, Ontario, Canada.

The incidence of bacteremia related to transesophageal echocardiography was studied in 140 consecutive patients (71 women and 69 men with a mean age of 53.7 +/- 15 years). Thirty-four patients had one or more prosthetic heart valves. Blood cultures were obtained from each patient through separate venipuncture sites immediately before and after transesophageal echocardiography. An additional late blood culture was obtained in 114 patients 1 h later. The skin was cleaned with povidone-iodine and venipunctures were performed with separate butterfly needles with use of sterile gloves and drapes. Blood samples were drawn into separate syringes, transferred to aerobic and anaerobic culture bottles and processed with use of a semiautomated system. The overall incidence of blood cultures positive for bacteremia was 2% (8 of 394 bottles) and all positive cultures grew in a single blood culture bottle. Positive cultures occurred in 4 (1.4%) of 280 bottles before the procedure, in 2 (0.7%) of 280 bottles immediately after the procedure and in 2 (0.9%) of 228 late (1-h) blood culture bottles. Bacterial isolates were coagulase-negative staphylococci (n = 5), Propionibacterium (n = 2) and Moraxella (n = 1). All were considered contaminants. Mean endoscopic time in these patients was not significantly different from that in the other patients. Follow-up of patients with a blood culture positive for bacteremia revealed no clinical evidence of systemic infection. It is concluded that 1) the incidence of bacteremia related to transesophageal echocardiography is very low, and 2) the incidence of blood cultures positive for bacteremia after transesophageal echocardiography is indistinguishable from the anticipated contamination rate.

This article has been cited by other articles:

				G. Cote and A. Denault Transesophageal echocardiography-related complications: [Complications associees a l'echocardiographie transoesophagienne] Can J Anesth, September 1, 2008; 55(9): 622 - 647. [Abstract] [Full Text] [PDF]

				R. T. Meenan, S. Saha, R. Chou, K. Swarztrauber, K. Pyle Krages, M. C. O'Keeffe-Rosetti, M. McDonagh, B. K. S. Chan, M. C. Hornbrook, and M. Helfand Cost-Effectiveness of Echocardiography to Identify Intracardiac Thrombus among Patients with First Stroke or Transient Ischemic Attack Med Decis Making, March 1, 2007; 27(2): 161 - 177. [Abstract] [PDF]

				J B Chambers, J L Klein, S R Bennett, M J Monaghan, and J C Roxburgh Is antibiotic prophylaxis ever necessary before transoesophageal echocardiography? Heart, April 1, 2006; 92(4): 435 - 436. [Abstract] [Full Text] [PDF]

				M.-R. Movahed, B. Kasravi, and C. S. Bryan Prophylactic Use of Vancomycin in Adult Cardiology and Cardiac Surgery Journal of Cardiovascular Pharmacology and Therapeutics, March 1, 2004; 9(1): 13 - 20. [Abstract] [PDF]

				J. M. DEACON, A. J. PAGLIARO, S. B. ZELICOF, and H. W. HOROWITZ Current Concepts Review - Prophylactic Use of Antibiotics for Procedures after Total Joint Replacement J. Bone Joint Surg. Am., November 1, 1996; 78(11): 1755 - 70. [Full Text]

				W. G. Daniel and A. Mugge Transesophageal Echocardiography N. Engl. J. Med., May 11, 1995; 332(19): 1268 - 1280. [Full Text] [PDF]

				BACTEREMIA IS RARE AFTER TRANSESOPHAGEAL ECHOCARDIOGRAPHY Journal Watch (General), December 17, 1991; 1991(1217): 7 - 7. [Full Text]