Etiological characteristics of infection after percutaneous biliary drainage or stent implantation for malignant biliary obstruction
10.3969/j.issn.1001-5256.2022.06.024
- VernacularTitle:恶性胆道梗阻经皮胆道引流或支架置入术后感染的病原学特征
- Author:
Siyin LI
1
;
Zhi LI
1
;
Bingke JIAO
1
;
Qiyuan HONG
1
;
Xiaoqing JIANG
1
;
Jianwei ZOU
1
;
Caifang NI
1
Author Information
1. Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China
- Publication Type:Original Articles_Biliary Diseases
- Keywords:
Malignant Biliary Obstruction;
Bacterial Infections;
Drug Resistance, Bacterial
- From:
Journal of Clinical Hepatology
2022;38(6):1347-1350
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the etiological characteristics of infection after percutaneous biliary drainage or stent implantation in patients with malignant biliary obstruction (MBO). Methods Clinical data were collected from MBO patients who underwent interventional therapy in Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, from January 2016 to December 2020 and had or were suspected of biliary tract infection, with samples submitted for bile culture and/or simultaneous blood culture. Analysis was performed for the aspects of positive rate of culture, flora distribution, consistency between blood culture and bile culture, and drug resistance rate of major pathogenic bacteria. Results A total of 219 patients were enrolled, among whom 105(47.95%) were positive for bile culture, and the composition ratios of Gram-negative bacteria, Gram-positive bacteria, and fungi were 64.89%, 28.24%, and 6.87%, respectively. A total of 69 patients had samples submitted for blood culture during the same period of time, among whom 33(47.82%) had positive results. Positive results of both bile culture and blood culture were observed in 25 patients, and consistency analysis showed that the patients with complete consistency, partial consistency, and complete inconsistency accounted for 36%(9/25), 20%(5/25), and 44%(11/25), respectively. Common Gram-negative bacteria were Escherichia coli , Klebsiella pneumoniae , and Enterobacter cloacae , with a relatively low level of drug resistance to antibiotics including cefoperazone/sulbactam, amikacin, and imipenem. Common Gram-positive bacteria were Enterococcus faecium and Enterococcus faecalis , with a relatively low level(< 15%) of drug resistance to antibiotics including vancomycin, linezolid, and teicoplanin. Conclusion Common pathogens of infection after percutaneous biliary drainage or stent implantation in MBO patients include Escherichia coli , Klebsiella pneumoniae , Enterococcus, and Enterobacter cloacae . There is a relatively low level of consistency between blood culture and bile culture, and thus samples should be submitted for both tests.
