Bacteriobilia in percutaneous transhepatic biliary drainage: occurrence over time and clinical sequelaeA prospective observational study

Rösch, T; Triptrap, A; Born, Peter; Ott, Raffael; Weigert, N.; Frimberger, E; Allescher, H. D.; Classen, Meinhard; Kamereck, K.

doi:10.1080/00365520310003549

Cited by 26 publications

(17 citation statements)

References 21 publications

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“…Two out of 19 patients with dominant stenosis who initially had sterile bile samples showed Candida in bile samples taken later in followup cholangiograms. Within the group of patients with dominant stenosis the median number of dilations was four [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] in the Candida group, four [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] in the enteric bacteria group, and four [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] in the sterile/ low-grade pathogen group.…”

Section: Resultsmentioning

confidence: 99%

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Biliary candida infections in primary sclerosing cholangitis

Kulaksiz¹,

Rudolph²,

Kloeters-Plachky³

et al. 2006

Journal of Hepatology

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Section: Resultsmentioning

confidence: 99%

“…Infections with Candida have been found to represent a frequent complication in patients with extrahepatic biliary obstruction undergoing percutaneous transhepatic biliary drainage [9].…”

Section: Discussionmentioning

confidence: 99%

Biliary candida infections in primary sclerosing cholangitis

Kulaksiz¹,

Rudolph²,

Kloeters-Plachky³

et al. 2006

Journal of Hepatology

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“…7,8 Therefore, the choice of antibiotics remains a challenge to the treating physician. Data on biliary tract candidiasis are emerging, but the clinical relevance and potential risk factors are still being debated.…”

Section: Introductionmentioning

confidence: 99%

Microbiological Assessment of Bile and Corresponding Antibiotic Treatment

et al. 2016

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The aim of this study was to determine the antibiotic susceptibility profiles of bacteria in bile samples and to analyze the clinical relevance of the findings as only limited information about risk factors for elevated frequence of bacterial and fungal strains in routinely collected bile samples has been described so far.A prospective cohort study at a tertiary care center was conducted. Seven hundred forty-four patients underwent 1401 endoscopic retrograde cholangiographies (ERCs) as indicated by liver transplantation (427/1401), primary sclerosing cholangitis (222/1401), choledocholithiasis only (153/1401), obstruction due to malignancy (366/1401), or other conditions (233/1401). Bile samples for microbiological analysis were obtained in all patients.The 71.6% (823/1150) samples had a positive microbiological finding, and 57% (840/1491) of the bacterial isolates were gram-positive. The main species were Enterococcus spp (33%; 494/1491) and Escherichia coli (12%; 179/1491). Of the samples, 53.8% had enteric bacteria and 24.7% had Candida spp; both were associated with clinical and laboratory signs of cholangitis (C-reactive proteins 35.0 ± 50.1 vs 44.8 ± 57.6; 34.5 ± 51.2 vs 52.9 ± 59.7; P < 0.001), age, previous endoscopic intervention, and immunosuppression. Multi-resistant (MR) strains were found in 11.3% of all samples and were associated with clinical and laboratory signs of cholangitis, previous intervention, and immunocompromised status. In subgroup analysis, strain-specific antibiotic therapy based on bile sampling was achieved in 56.3% (89/158) of the patients. In cases with a positive bile culture and available blood culture, blood cultures were positive in 29% of cases (36/124), and 94% (34/36) of blood cultures had microbial species identical to the bile cultures.Bactobilia and fungobilia can usually be detected by routine microbiological sampling, allowing optimized, strain-specific antibiotic treatment. Previous endoscopic intervention, clinical and laboratory signs of cholangitis, and age are independent risk factors. MR bacteria and fungi are an evolving problem in cholangitis, especially in immunocompromised patients.

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“…The incidence of nau sea (8%) was similar to that in other studies, and nausea was well controlled with conser vative treatment, including metoclopramide. Postprocedural shivering (6%), which can be partly due to biliary sepsis, developed with an incidence similar to that recorded previ ously [23]. Thoracic and muscle rigidity can occur when higher doses of a rapidonset opioid are injected; pruritus did not develop in this study.…”

Section: Remifentanil For Percutaneous Transhepatic Biliary Drainagementioning

confidence: 49%