BACKGROUND Infectious complications after endobronchial ultrasound-guided transbronchial biopsy with a guide sheath (EBUS-GS-TBB) are serious in that they may delay or change scheduled subsequent therapy. The aim of this study was to identify risk factors for infection after EBUS-GS-TBB. METHODS We retrospectively reviewed the medical records of 1,045 consecutive patients who had undergone EBUS-GS-TBB for peripheral lung lesions between January 2013 and December 2017 at Fujita Health University Hospital. We evaluated the following risk factors for infectious complications after EBUS-GS-TBB: relevant patient characteristics (age, comorbidities), lesion size, CT features of target lesion (intratumoral low-density areas [LDAs], cavitation), stenosis of responsible bronchus observed by bronchoscopy, and laboratory data before EBUS-GS-TBB (white blood cell count and C-reactive protein concentration). RESULTS Forty-seven of the studied patients developed infectious complications (24 pneumonia, 14 intratumoral infection, 3 lung abscess, 3 pleuritis, 3 empyema), among whom the complication caused a delay in cancer treatment in 13 patients, cancellation of cancer treatment in 7, and death in 3. Multivariate analysis showed that cavitation (P=.007), intratumoral LDAs (P<.001), and stenosis of responsible bronchus observed by bronchoscopy (P<.001) were significantly associated with infectious complications after EBUS-GS-TBB. Prophylactic antibiotics had been administered to 13 patients in the infection group. Propensity matched analysis could not show significant benefit of prophylactic antibiotics in preventing post-EBUS-GS-TBB infections. CONCLUSIONS Cavitation, LDAs for CT features of target lesions, and stenosis of responsible bronchus observed by bronchoscopy are risk factors of post-EBUS-GS-TBB infection. In our cohort, prophylactic antibiotics failed to prevent infectious complications.

中文翻译：

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支气管内超声引导下经支气管活检后感染并发症的危险因素

背景 带引导鞘的支气管内超声引导经支气管活检 (EBUS-GS-TBB) 后的感染并发症很严重，因为它们可能会延迟或改变预定的后续治疗。本研究的目的是确定 EBUS-GS-TBB 后感染的危险因素。方法 我们回顾性回顾了 2013 年 1 月至 2017 年 12 月在藤田健康大学医院接受 EBUS-GS-TBB 治疗的 1,045 名连续患者的医疗记录。我们评估了 EBUS-GS-TBB 后感染并发症的以下危险因素：相关患者特征（年龄、合并症）、病灶大小、目标病灶的 CT 特征（肿瘤内低密度区 [LDA]、空洞）、责任支气管狭窄通过支气管镜观察，EBUS-GS-TBB 之前的实验室数据（白细胞计数和 C 反应蛋白浓度）。结果 47例研究患者出现感染性并发症（肺炎24例，瘤内感染14例，肺脓肿3例，胸膜炎3例，脓胸3例），其中13例患者因并发症延迟癌症治疗，7例癌症治疗取消。和死亡 3. 多变量分析显示空化 (P=.007)、瘤内 LDA (P<.001) 和支气管镜检查观察到的责任支气管狭窄 (P<.001) 与 EBUS 后感染并发症显着相关。 GS-TBB。感染组的 13 名患者接受了预防性抗生素治疗。倾向匹配分析不能显示预防性抗生素在预防 EBUS-GS-TBB 感染后的显着益处。结论空洞、靶病变CT特征LDA、支气管镜观察到的责任支气管狭窄是EBUS-GS-TBB感染后的危险因素。在我们的队列中，预防性抗生素未能预防感染性并发症。