Acute (Ascending) Cholangitis

Hanau, Lawrence H.; Steigbigel, Neal H.

doi:10.1016/s0891-5520(05)70119-7

Cited by 148 publications

(111 citation statements)

References 219 publications

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“…Aerobic bacteria, such as Escherichia coli, Klebsiellapneumoniae, Enterococcus spp., and Enterobacter, are most frequently isolated (8,13,15,(20)(21)(22). The results of our study support this finding.…”

Section: Discussionsupporting

confidence: 88%

“…In past studies, 16%-85% reproduction was determined (4,(8)(9)(10)(11)(12)(13)(14). In older studies, 30%-90%polymicrobial reproduction in bile cultures was determined, especially in patients whose bile ducts had previous interference (15)(16)(17)(18)(19).…”

Section: Discussionmentioning

confidence: 99%

“…Blood cultures provide an opportunity to determine effective organisms. In past studies, in patients with cholangitis, reproduction in blood cultures was reported as 20%-80% (14,15,(23)(24)(25)(26)(27). The low reproduction rates in our blood cultures could have been because cases that did not have cholangitis were included in the study.…”

Section: Discussionmentioning

confidence: 99%

“…A number of changes in neutrophil function have also been noted in patients with obstructive jaundice, such as reduced phagocytosis, impaired adhesion, and abnormal response to cytokines. All these changes may diminish the neutrophil response to infection (15,32). Inaddition, some studies have shown impaired phagocytic function of the Kupffer cells in animal models of biliary obstruction, with recovery when the obstruction is relieved (38).…”

Section: Discussionmentioning

confidence: 99%

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The change in microorganisms reproducing in bile and blood culture and antibiotic susceptibility over the years

Suna

Yıldız²,

Yüksel³

et al. 2014

Turk J Gastroenterol

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Background/Aims: Infection in the bile tract is a major cause of bacteremia and is related to high morbidity and mortality. We examined the changes in bacteria types and antibiotic susceptibility in bile cultures and simultaneous blood cultures taken from patients who applied for endoscopic retrograde cholangio pancreatography (ERCP)/ percutaneous transhepatic cholangiography (PTC) for different bile duct diseases in recent years. Materials and Methods: Bacteria types that reproduce in bile and blood cultures from patients who applied for ERCP/PTC between the years of 2007 and 2012 in our clinic were examined. All patients were evaluated together, and in addition, the periods between 2007 and 2009 (Group 1) and between 2010 and 2012 (Group 2) were compared. Results: In total, 550 patients applied to this study. There were 266 patients in Group 1 and 284 in Group 2. Reproduction occurred in 77.6% of bile cultures. In the order of frequency, these cultures consisted of Escherichia coli (32.8%), Enterococcus spp. (26.2%), and Pseudomonas aeruginosa (11%). Enterococcus spp. were determined to be higher in Group 2 than Group 1 (p<0.016). Resistance to quinolones was found in 74.1% of patients, to ampicillin in 73.2%, and to cephalosporins in an average of 61%. Vancomycin was the most susceptible antibiotic (93.4%) to gram-positives. Resistance to piperacillin-tazobactam and amikacin was higher in Group 2 than Group 1 (p=0.001 and p=0.003, respectively). Conclusion:The most frequently reproducing bacteria in the bile cultures evaluated in our hospital were Escherichia coli and Enterococcus spp. Although it was thought that the antibiotics given empirically were effective against these bacteria, there was resistancerate of 75% in our study. We determined that the first-and second-step treatment protocols must be updated.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The change in microorganisms reproducing in bile and blood culture and antibiotic susceptibility over the years

Suna

Yıldız²,

Yüksel³

et al. 2014

Turk J Gastroenterol

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“…Patients are febrile, often have abdominal pain, and are jaundiced [4]. There is usually leukocytosis, and serum alkaline phosphatase and bilirubin levels are generally elevated [4,5]. Approximately 85% of cases are caused by an impacted stone in the common bile duct, with resulting bile stasis [6].…”

Section: Introductionmentioning

confidence: 99%

Cholangitis of Pancreatitis? Does the Angiotensin-Converting Enzyme Genotype Favor Either?

Kasap

Akyıldız

Akarca

2009

Balkan Journal of Medical Genetics

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Acute cholangitis and pancreatitis are serious complications of gallstones, with considerable morbidity and mortality. Angiotensin-converting enzyme (ACE) is an exopeptidase that is important in regulating blood pressure, metabolizing bradykinin and in maintaining an inflammatory response. To determine whether the ACE genotype determines occurrence of cholangitis or pancreatitis we examined ACE I/D genotypes in 31 patients who had cholangitis, 44 patients with biliary pancreatitis and 157 healthy individuals. The patients had been hospitalized at the Department and Intensive Care Faculty of Medicine, Ege University, İzmir, Turkey. The patients were recalled 4 years later and their prognosis was evaluated. The ACE II genotype was found at a higher frequency in the cholangitis and biliary pancreatitis patients when compared with the healthy subjects (p <0.05). There was no significant difference between cholangitis and biliary pancreatitis cases regarding the genotype and allele distribution (p >0.05). Recurrence of infection occurred more frequently in the patients with the DD genotype, although it was not significant according to the first assessment (p >0.05). The ACE gene polymorphism did not seem to favor development of either cholangitis or pancreatitis.

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