Bacteremia with esophageal dilation

Gastrointest Endosc. 1998 Dec;48(6):563-7. doi: 10.1016/s0016-5107(98)70036-7.


Background: Antibiotic prophylaxis has been recommended for selected patients undergoing esophageal stricture dilation because of a reported high rate of bacteremia. The aim of this study was to determine the rate of bacteremia after esophageal dilatation in a large series and the source of the organisms recovered.

Methods: Blood cultures and oral temperatures were obtained before esophageal dilation and at 5 and 30 minutes after dilation. Dilators were cultured immediately before dilation. Procedural data collected included type of dilation, number of passes, and presence of malignancy.

Results: Of 100 procedures in 86 patients undergoing esophageal dilation, 22 (22%) were associated with a positive post-dilation blood culture. Bacteremia was more frequent with dilation of malignant strictures compared with benign strictures (9 of 17 [52.9%] vs. 13 of 83 [15.7%], respectively, p = 0.002) and with passage of multiple dilators compared with passage of a single dilator (16 of 46 [34.8%] versus 6 of 54 [11.1%], respectively, p = 0.007). Bacterial isolates from 22 positive blood cultures matched those from a dilator in only one episode (4.5%).

Conclusion: The rate of bacteremia after esophageal dilation is 22% and is associated with dilation of malignant strictures or passage of multiple dilators. Organisms cultured from the blood are not transmitted from the dilator.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacteremia / epidemiology
  • Bacteremia / etiology*
  • Dilatation / adverse effects
  • Dilatation / instrumentation
  • Disinfection
  • Equipment Contamination
  • Esophageal Neoplasms / complications
  • Esophageal Stenosis / etiology
  • Esophageal Stenosis / therapy*
  • Humans
  • Risk Factors
  • Time Factors