Changing Patterns of Causative Pathogens over Time and Efficacy of Empirical Antibiotic Therapies in Acute Cholangitis with Bacteremia

Jeong, Han Taek; Song, JooSeok; Kim, Ho Gak; Han, Jimin

doi:10.5009/gnl210474

Cited by 4 publications

(1 citation statement)

References 32 publications

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“…was the most commonly reported in patients with stent occlusion (65%) when compared with the other group (P=0.027). In agreement with this study, a study on 568 patients with acute cholangitis reported that the most common pathogen was Klebsiella (10) . Additionally, a study reported that Klebsiella spp.…”

Section: Discussionsupporting

confidence: 90%

Association Between Bacterial Colonization and Stent Occlusion in Plastic Biliary Stents

Ramadan,

Abdel Gaffar,

Atef

et al. 2024

Benha Medical Journal

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Background: Biliary stent occlusion is a significant clinical concern with potentially severe consequences for patients. This study aimed to evaluate common microorganisms detected by culture from plastic biliary stents, assess their association with stent occlusion, and evaluate their antimicrobial sensitivity. Methods: Forty patients with plastic biliary stents were included in this study. They were divided into two groups: Group (I) 20 patients with clinical signs of stent occlusion and Group (II) 20 patients scheduled for stent extraction within three months after placement. Various clinical, laboratory, and imaging assessments were conducted. The plastic stents were extracted and subjected to microbiological culture to identify aerobic and anaerobic organisms, followed by antimicrobial sensitivity testing. Results: Patients in Group (I) exhibited a higher prevalence of clinical symptoms indicative of stent occlusion, abnormal vital signs, and elevated laboratory parameters (TLC, ESR, CRP, Total Bilirubin., Direct Bilirubin, ALP, ALT, AST, PT, INR and creatinine) compared to Group (II). Microbiological analysis revealed the presence of various organisms, with Klebsiella sp, Proteus, Pseudomonas, and E. coli being the most common. Sensitivity and resistance to antibiotics varied among these microorganisms. Conclusion: Klebsiella was prevalent in stent occlusion (65%), while Proteus dominated non-occlusion (60%). No anaerobic organisms were found. Amikacin, Meropenem, and Imipenem showed the highest sensitivity of microbes in patient with stent occlusion, and Meropenem, Colistin, and Imipenem the highest sensitivity of microbes in patient with non-stent occlusion. Both groups exhibited 100% resistance to various antibiotics.

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Section: Discussionsupporting

confidence: 90%

Association Between Bacterial Colonization and Stent Occlusion in Plastic Biliary Stents

Ramadan,

Abdel Gaffar,

Atef

et al. 2024

Benha Medical Journal

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Epidemiology of biliary tract-associated bloodstream infections and adequacy of empiric therapy: an Australian population-based study

Gassiep,

Edwards,

Laupland

2024

Eur J Clin Microbiol Infect Dis

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Purpose Although the biliary tract is a common source of invasive infections, the epidemiology of cholangitis- and cholecystitis-associated bloodstream infection (BSI) is not well defined. The objective of this study was to determine the incidence, clinical determinants, microbiology of biliary tract-associated BSI, and predicted adequacy of common empiric therapy regimens. Methods All biliary tract-associated BSI in Queensland during 2000–2019 were identified using state-wide data sources. Predicted adequacy of empiric antimicrobial therapy was determined according to microbiological susceptibility data. Results There were 3,698 episodes of biliary tract-associated BSI occurred in 3,433 patients of which 2,147 (58.1%) episodes were due to cholangitis and 1,551 (41.9%) cholecystitis, for age- and sex-standardized incidence rates of 2.7, and 2.0 per 100,000 population, respectively. An increasing incidence of biliary tract-associated BSI was observed over the study that was attributable to an increase in cholangitis cases. There was a significant increased risk for biliary tract-associated BSI observed with advancing age and male sex. Patients with cholangitis were older, more likely to have healthcare associated infection, and have more comorbidities most notably liver disease and malignancies as compared to patients with cholecystitis. The distribution of infecting pathogens was significantly different with polymicrobial aetiologies more commonly observed with cholangitis (18.4% vs. 10.5%; p < 0.001). The combination of ampicillin/gentamicin/metronidazole was predicted to have the overall highest adequacy (96.1%), whereas amoxicillin/clavulanate had the lowest (77.0%). Amoxicillin/clavulanate (75.2% vs. 79.4%, p:0.03) and ceftriaxone/metronidazole (83.4% vs. 89.6%; p < 0.001) showed significantly inferior predicted adequacy for cholangitis as compared to cholecystitis. Conclusions Bloodstream infections related to cholecystitis and cholangitis exhibit different epidemiology, microbiology, and requirements for empiric therapy.

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Outcomes and predictors of delayed endoscopic biliary drainage for severe acute cholangitis due to choledocholithiasis in an intensive care unit

Hedjoudje¹,

Cheurfa²,

Talby³

et al. 2023

Digestive and Liver Disease

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Changing Patterns of Causative Pathogens over Time and Efficacy of Empirical Antibiotic Therapies in Acute Cholangitis with Bacteremia

Cited by 4 publications

References 32 publications

Association Between Bacterial Colonization and Stent Occlusion in Plastic Biliary Stents

Association Between Bacterial Colonization and Stent Occlusion in Plastic Biliary Stents

Epidemiology of biliary tract-associated bloodstream infections and adequacy of empiric therapy: an Australian population-based study

Outcomes and predictors of delayed endoscopic biliary drainage for severe acute cholangitis due to choledocholithiasis in an intensive care unit

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