Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Palermo, Italy.
School of Medicine and Surgery, University Federico II of Naples, Naples, Italy.
Eur J Clin Microbiol Infect Dis. 2018 May;37(5):953-958. doi: 10.1007/s10096-018-3213-y. Epub 2018 Feb 27.
Bile is a lipid-rich sterile solution produced in the liver that can be infected resulting in bactibilia. A higher incidence of postoperative infectious complications has been seen in patients with bactibilia. Recently, gram-negative bacteria have been linked to a tumor-associated inflammatory status. This study is a retrospective cohort study of 39 patients, who are over 80 years of age only (53.85% males and 46.15% females), hospitalized with diseases of the biliopancreatic system in one teaching hospital in Italy from January 2011 to December 2012 with a follow-up of 5 years. The most common biliary diseases after surgery were pancreatic head cancer (p < 0.0001) and gallbladder cancer (p = 0.0051), while the most common bacteria in the bile were E. coli (p = 0.0180) and Pseudomonas spp. (p < 0.0001). Uni- and multivariate linear correlation analysis revealed that patients with pancreatic head cancer had low survival times compared to patients with other diseases. Moreover, the bacterium type was a positive predictor of survival time compared to other variables. Our data confirm E. coli as a pathogen in patients with gallbladder and pancreatic cancer. Although the influence of bactibilia in developing surgical complications is limited, we consider that its composition is crucial to properly address the antibiotic treatment in biliary tract infections, especially in the elderly.
胆汁是肝脏产生的富含脂质的无菌溶液，可能受到感染，导致细菌进入胆汁。患有细菌进入胆汁的患者术后感染性并发症的发生率较高。最近，革兰氏阴性菌与肿瘤相关的炎症状态有关。本研究是对意大利一家教学医院 2011 年 1 月至 2012 年 12 月期间因胆胰系统疾病住院的 39 名 80 岁以上（53.85%为男性，46.15%为女性）患者进行的回顾性队列研究，随访 5 年。术后最常见的胆道疾病是胰头癌（p<0.0001）和胆囊癌（p=0.0051），而胆汁中最常见的细菌是大肠杆菌（p=0.0180）和假单胞菌属（p<0.0001）。单变量和多变量线性相关分析显示，与其他疾病患者相比，胰头癌患者的存活时间较短。此外，与其他变量相比，细菌类型是存活时间的正预测因子。我们的数据证实大肠杆菌是胆囊癌和胰腺癌患者的病原体。尽管细菌进入胆汁对发生手术并发症的影响有限，但我们认为其成分对于正确解决胆道感染的抗生素治疗至关重要，尤其是在老年人中。
