Risk of Bacterial Colonization of Pancreatic Stents Used in Endoscopic Retrograde Cholangiopancreatography

Hill, Sean; Bhalla, Christopher; Thomson, Andrew

doi:10.1097/mcg.0b013e31823712cc

Cited by 10 publications

(3 citation statements)

References 9 publications

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“…Ascending bacterial colonization can occur through retrograde migration from the intestinal lumen (more likely after pancreatic surgery) or through the formation of a biofilm on the surface of pancreatic duct stents . More specifically, a recent study by Hill et al . cultured pancreatic duct stents placed by a single operator at a tertiary referral center and reported that 28 of 47 stents grew clinically significant bacteria, and the majority of which belonged to the Enterobacteriaceae family of gram‐negative bacteria, a finding consistent with our report.…”

Section: Discussionsupporting

confidence: 90%

The impact of bacterial colonization on graft success after total pancreatectomy with autologous islet transplantation: considerations for early definitive surgical intervention

Jolissaint

Langman

DeBolt

et al. 2016

Clinical Transplantation

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Objective The purpose of this study was to determine whether bacterial contamination of islets affects graft success after total pancreatectomy with islet autotransplantation (TPIAT). Background Factors associated with insulin independence after TPIAT are inconclusive. Although bacterial contamination does not preclude transplantation, the impact of bacterial contamination on graft success is unknown. Methods Patients who received TPIAT at the University of Virginia between January 2007 and January 2016 were reviewed. Patient charts were reviewed for bacterial contamination and patients were prospectively contacted to assess rates of insulin-independence. Results There was no significant difference in demographic or perioperative data between patients who achieved insulin-independence and those who did not. However, six of 27 patients analyzed (22.2%) grew bacterial contaminants from culture of the final islet preparations. These patients had significantly lower islet yield and C-peptide at most recent follow-up (p<0.05), and none of these patients achieved insulin-independence. Conclusions Islet transplant solutions are often culture-positive, likely secondary to pre-procurement pancreatic manipulation and introduction of enteric flora. Although autotransplantation of culture-positive islets is safe, it is associated with higher rates of graft failure and poor islet yield. Consideration should be given to identify patients who may develop refractory chronic pancreatitis and offer early operative management to prevent bacterial colonization.

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Section: Discussionsupporting

confidence: 90%

The impact of bacterial colonization on graft success after total pancreatectomy with autologous islet transplantation: considerations for early definitive surgical intervention

Jolissaint

Langman

DeBolt

et al. 2016

Clinical Transplantation

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“…In regard to the route of bacterial invasion from the intestine to the pancreas, we found that preoperative stent placement was one of the independent risk factors of bacterial contamination (odds ratio 6.7, P = .025). It is likely that sphincterotomy performed for stent placement allowed bacteria to invade the main pancreatic duct . This story mirrors that in previous studies of biofilm covering pancreatic duct stents .…”

Section: Discussionsupporting

confidence: 69%

Impact of microbial contamination of the islet product during total pancreatectomy with islet autotransplantation

Kumano

Takita

Vasu

et al. 2020

J Hepato Biliary Pancreat

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Background:The combined use of interleukin-1β and tumor necrosis factor-α blockers in the peritransplant period has improved outcomes of total pancreatectomy with islet autotransplantation (TPIAT). However, these drugs may suppress the immune system, resulting in severe infection. Methods: We retrospectively investigated the impact of microbial-contaminated islet product on posttransplant complications and metabolic outcomes of TPIAT patients receiving the IL-1β and TNF-blockade treatment at our center. Results: Among 108 TPIAT patients, 37 patients (34%) received contaminated products. Preoperative stent treatment and fibrosis score were independent risk factors for the contamination. There were no significant differences between the contaminated and noncontaminated product groups in posttransplant infectious complication rate, length of hospitalization, or readmission rate. However, islet equivalents (P < .0001) and insulin independence rate (P = .036) at 6 months were significantly lower for patients receiving contaminated product. Conclusions: These results suggest that combined anti-inflammatory drug use is safe and well tolerated in TPIAT patients who receive contaminated islet product and does not increase the rate of infectious complications; however, contaminated islet product is associated with poor metabolic outcomes.

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“…Though gut appears to be the main source of bacteria for stent occlusion, at times gram-positive bacteria, such as, Staphylococcus aureus, Enterococcus, and anaerobes can also be found. Hill et al 28 reported bacterial growth composed of bacteria, such as, Klebsiella, Escherichia, Enterobacter, and Enterococcus in 28/47 retrieved pancreatic stents, with a strong correlation between the duration of indwelling stents and the bacterial growth. The species diversity of pancreatic stent biofilms was further testified in a study that characterized more than 246 resident species.…”

Section: Pancreatic Biofilmsmentioning

confidence: 99%

Microbial Biofilms in Biliary and Pancreatic Stents

Vaishnavi¹,

Bush²,

Kochhar³

2020

Journal of Gastrointestinal Infections

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Risk of Bacterial Colonization of Pancreatic Stents Used in Endoscopic Retrograde Cholangiopancreatography

Cited by 10 publications

References 9 publications

The impact of bacterial colonization on graft success after total pancreatectomy with autologous islet transplantation: considerations for early definitive surgical intervention

The impact of bacterial colonization on graft success after total pancreatectomy with autologous islet transplantation: considerations for early definitive surgical intervention

Impact of microbial contamination of the islet product during total pancreatectomy with islet autotransplantation

Microbial Biofilms in Biliary and Pancreatic Stents

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