Clinical characteristics and pathogens in percutaneous endoscopic gastrostomy site infection in patients with head and neck cancer: A 16-year retrospective study

Objectives Wound infection is the most common complication associated with percutaneous endoscopic gastrostomy (PEG) placement, with an incidence between 4% and 30%. In this study, we compared the characteristics of PEG site infection between the head and neck cancer (HNC) group and the non-HNC group. Methods This study was conducted at Kangdong Sacred Heart Hospital at the Ilsong Head and Neck Cancer Center. We retrospectively collected and analyzed data on patients who underwent PEG insertion from October 2003 to May 2019 to evaluate the risk factors and microbiological etiologies of PEG site infection. Results A total of 316 (HNC group [n = 129] and non-HNC group [n = 187]) patients undergoing PEG insertion were included in this study. Moreover, 67 episodes of PEG site infection were diagnosed, with an overall prevalence of 21.2%. PEG site infections were significantly higher in the HNC group than in the non-HNC group (32.6% vs 13.4%, P <.001). Pseudomonas aeruginosa is the most common pathogen associated with a PEG site infection. Multidrug-resistant (MDR) P aeruginosa was more frequent in the HNC group than in the non-HNC group (78.6% vs 25.0%, P = .006). Conclusions For appropriate treatment, P aeruginosa, especially MDR P aeruginosa, should be considered when selecting empirical antibiotics for PEG site infection in patients with HNC. Level of Evidence: 4

Automated summary

This study compared the characteristics of PEG site infection between head and neck cancer and non-head and neck cancer groups, with a higher infection rate observed in the head and neck cancer group, primarily caused by Pseudomonas aeruginosa. Therefore, when selecting empirical antibiotics for PEG site infection patients, consideration should be given to multidrug-resistant P. aeruginosa.