Nutrition is an important determinant of health in elderly patients. It also contributes to their overall quality of life and longevity. Percutaneous endoscopic gastrostomy (PEG) tube is used to provide enteral access in patients who are unable to swallow to improve nutrition. PEG site infection is an important healthcare-associated infection and this study aims to determine the incidence and clinical profile of PEG site wound infections among elderly patients admitted in a tertiary medical center.
A total of 102 frail elderly patients underwent PEG insertion from May 2017 to April 2018. Clinical and microbiological data were collected for culture-positive cases.
A total of 30 PEG site wound infections occurred (29.4%). Sixteen organisms were isolated. Klebsiella pneumonia was the most common (n = 17) followed by Pseudomonas aeruginosa (n = 6). Most of the infections (43%) were detected in the first 14 days post procedure. Most elderly patients with wound infections have cardiovascular & neurologic disease, diabetes mellitus, anemia and hypoalbuminemia. There was seven Carbapenemase producing and six Extended spectrum beta-lactamases producing Enterobacteriaceae. Four Gram-negative Multi-drug resistant organisms. Polymicrobial infection was noted in half of the patients (53%). The 30-day mortality rate was 6.8%.
PEG site wound infection is a common problem with clinical impact to elderly patients. The study was able to provide an epidemiologic data of PEG site wound infections among frail elderly patients and will provide clinicians and hospital personnel a guide to infection prevention and treatment strategies in hospitals.