Journal of hepato-biliary-pancreatic sciences · 2025
Microbiological Characteristics of Pathogens Isolated From Blood Cultures of Patients With Acute Cholangitis: Insights From Patients With Biliary-Enteric Anastomosis.
СтатьяНазвание и аннотация: Перевод в очереди
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Kuhara Yuta, Kitagawa Hiroki, Kaiki Yuki, Omori Keitaro, Shigemoto Norifumi, Akita Tomoyuki, Uemura Kenichiro, Fukuma Shingo, Takahashi Shinya, Ohge Hiroki
Аннотация
BACKGROUND: We aimed to investigate the microbiological characteristics of pathogens isolated from blood cultures (BCs) of patients with acute cholangitis (AC) after biliary-enteric anastomosis and biliary intervention (BI).
METHODS: A retrospective analysis was conducted on 366 patients with AC and bacteremia between 2015 and 2024 at Hiroshima University Hospital. Patients were categorized into three groups: post-biliary reconstruction-associated AC (PBR-AC), BI-associated AC (BI-AC), and common AC (C-AC). Patients' clinical and microbiological data were statistically analyzed in each group.
RESULTS: The most frequently isolated pathogens were Escherichia coli and Klebsiella spp., accounting for > 50% of isolates in all groups. ESCPM spp. (Enterobacter spp., including Klebsiella aerogenes, Serratia marcescens, Citrobacter freundii complex, Providencia spp., and Morganella morganii) were significantly associated with PBR- and BI-AC compared with C-AC. No significant differences in the prevalence of anaerobic bacteria were observed among the groups.
CONCLUSIONS: The prevalence of ESCPM spp. isolated from BCs was significantly higher in the PBR- and BI-AC groups than in the C-AC group. The presence of biliary-enteric anastomosis or BI history should be checked when determining the treatment strategy for AC. Cefepime may be a better antibiotic option for PBR- and BI-AC, particularly in severe cases.
METHODS: A retrospective analysis was conducted on 366 patients with AC and bacteremia between 2015 and 2024 at Hiroshima University Hospital. Patients were categorized into three groups: post-biliary reconstruction-associated AC (PBR-AC), BI-associated AC (BI-AC), and common AC (C-AC). Patients' clinical and microbiological data were statistically analyzed in each group.
RESULTS: The most frequently isolated pathogens were Escherichia coli and Klebsiella spp., accounting for > 50% of isolates in all groups. ESCPM spp. (Enterobacter spp., including Klebsiella aerogenes, Serratia marcescens, Citrobacter freundii complex, Providencia spp., and Morganella morganii) were significantly associated with PBR- and BI-AC compared with C-AC. No significant differences in the prevalence of anaerobic bacteria were observed among the groups.
CONCLUSIONS: The prevalence of ESCPM spp. isolated from BCs was significantly higher in the PBR- and BI-AC groups than in the C-AC group. The presence of biliary-enteric anastomosis or BI history should be checked when determining the treatment strategy for AC. Cefepime may be a better antibiotic option for PBR- and BI-AC, particularly in severe cases.