BACKGROUND: Airway stenting is nowadays an established method for the palliative and/or curative treatment of central airways obstruction. However, complications related to the use of airway stents have been reported. OBJECTIVE: We endeavored to systematically evaluate the currently available evidence regarding the infections associated with airway stenting. METHODS: We independently searched in PubMed for relevant reports. We considered articles which reported on clinical infections related to airway stenting. A case was identified as stent-associated respiratory tract infection (SARTI) according to the authors of the individual papers, based on clinical findings with or without radiological or microbiological confirmation. RESULTS: Twenty-three articles (19 cohorts/case series and 4 case reports), involving 501 patients with airway stents, were included. The indication for airway stenting was malignancy and benign disease in 45 and 55% of the included patients, respectively. Ninety-three (19%) out of the 501 stented patients experienced SARTI. Pneumonia was the most common type of SARTI (47%), followed by bronchial infection (24%), cavitary pneumonia/lung abscess and intraluminal fungus ball. Staphylococcus aureus (39%) and Pseudomonas aeruginosa (28%) were the most commonly identified pathogens. Twenty-six (68%) out of the 38 patients with SARTI, for whom outcome data were available, died. CONCLUSION: The accumulated and evaluated evidence suggests that SARTI probably involves 1 in 5 patients with airway stent. Although the possibility of SARTI should not discourage the interventional pneumologists from inserting airway stents, the data seem to underline the urgent need for establishing a consensus definition and diagnostic criteria for SARTI. Copyright 2009 S. Karger AG, Basel.
BACKGROUND: Airway stenting is nowadays an established method for the palliative and/or curative treatment of central airways obstruction. However, complications related to the use of airway stents have been reported. OBJECTIVE: We endeavored to systematically evaluate the currently available evidence regarding the infections associated with airway stenting. METHODS: We independently searched in PubMed for relevant reports. We considered articles which reported on clinical infections related to airway stenting. A case was identified as stent-associated respiratory tract infection (SARTI) according to the authors of the individual papers, based on clinical findings with or without radiological or microbiological confirmation. RESULTS: Twenty-three articles (19 cohorts/case series and 4 case reports), involving 501 patients with airway stents, were included. The indication for airway stenting was malignancy and benign disease in 45 and 55% of the included patients, respectively. Ninety-three (19%) out of the 501 stented patients experienced SARTI. Pneumonia was the most common type of SARTI (47%), followed by bronchial infection (24%), cavitary pneumonia/lung abscess and intraluminal fungus ball. Staphylococcus aureus (39%) and Pseudomonas aeruginosa (28%) were the most commonly identified pathogens. Twenty-six (68%) out of the 38 patients with SARTI, for whom outcome data were available, died. CONCLUSION: The accumulated and evaluated evidence suggests that SARTI probably involves 1 in 5 patients with airway stent. Although the possibility of SARTI should not discourage the interventional pneumologists from inserting airway stents, the data seem to underline the urgent need for establishing a consensus definition and diagnostic criteria for SARTI. Copyright 2009 S. Karger AG, Basel.
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Authors: David E Ost; Armin Ernst; Horiana B Grosu; Xiudong Lei; Javier Diaz-Mendoza; Mark Slade; Thomas R Gildea; Michael S Machuzak; Carlos A Jimenez; Jennifer Toth; Kevin L Kovitz; Cynthia Ray; Sara Greenhill; Roberto F Casal; Francisco A Almeida; Momen M Wahidi; George A Eapen; David Feller-Kopman; Rodolfo C Morice; Sadia Benzaquen; Alain Tremblay; Michael Simoff Journal: Chest Date: 2015-05 Impact factor: 9.410
Authors: Horiana B Grosu; George A Eapen; Rodolfo C Morice; Carlos A Jimenez; Roberto F Casal; Francisco A Almeida; Mona G Sarkiss; David E Ost Journal: Chest Date: 2013-08 Impact factor: 9.410
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