Twenty-three studies (n=501) were included in the review (12 retrospective cohorts, three prospective cohorts, four retrospective case series, and four case reports).
Nineteen per cent of all patients experienced a stent-associated respiratory tract infection (16% in patients with malignant disease, 19% in patients with benign disease; 21% for metallic stents, 20% for polymeric stents and 23% for hybrid stents). Complications (reported in 19 studies, n=93) included pneumonia (47%), bronchial infection (24%), cavitary pneumonia/lung abscess (2%) and intraluminal fungus ball (2%).
Twenty-six out of the 38 patients with stent-associated respiratory tract infection, for whom outcome data was available, died (76% for patients with malignant disease, 88% for transplant patients and 42% for non-transplant benign patients). Stent removal or replacement was required for treatment of six patients with bronchial infection and one patient with recurrent pneumonia associated with tumour overgrowth. Five different types of pathogen were found Only three cases of antimicrobial treatment were reported (results were provided).