PURPOSE: There are a few data regarding the risk of bacteremia with fine needle aspiration from within the bronchial tree. The aim of this prospective study was to evaluate the frequency of bacteremia and other infectious complications associated with EBUS-TBNA.
METHODS: Patients referred for EBUS-TBNA for mediastinal lesions and/or lymph nodes were considered for enrolment. They were excluded if they had taken antibiotics within the prior 7 days, if they had a kystic mediastinal lesion or if they were unable to give informed consent. Blood cultures were obtained immediately before (nb 1) the procedure, 5 minutes (nb 2) and 30 minutes (nb 3) after the end of the procedure. Patients were contacted by phone within two weeks to assess whether they had experienced fever and/or infections or whether they had been treated with antibiotics.
RESULTS: Sixty-seven patients underwent EBUS-TBNA in 136 mediastinal areas (mean : 2.0 areas/patient) and a total number of 351 fine needle passes were performed (mean : 5.2 passes/patient). Positive blood cultures were noticed in only five (7%) patients.In two cases, only the first blood culture performed before EBUS was positive for a skin contaminant (Staphylococcus epidermidis). In three patients, nb 2 positive blood cultures with/without nb 3 positive blood cultures were observed. Bacillus species, Staphylococcus hominis and epidermidis were observed, likely to be contaminant. On the opposite, one blood culture in each of these three cases concerned bacteria that may originate from the oropharyngeal area: Gemella morbillorum (blood culture nb 2, subject 63), Streptococcus mitis (blood culture nb 3, subject 56) and Streptococcus viridans (blood culture nb 3, subject 62).Two patients (3 %) presented fever 4 or 5 hours after the procedure, with negative blood cultures. One patient was treated with antibiotics for bronchitis without fever 5 days after EBUS.
CONCLUSION: EBUS-TBNA of mediastinal lesions should be considered a low risk procedure for infectious complications.
CLINICAL IMPLICATIONS: Our data do not seem to support prophylactic administration of antibiotics for prevention of bacterial endocarditis.
DISCLOSURE: Christophe Compère, No Financial Disclosure Information; No Product/Research Disclosure Information