Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Scand J Gastroenterol. 2021 May;56(5):578-584. doi: 10.1080/00365521.2021.1902558. Epub 2021 Mar 25.
Acute cholangitis (AC) is a condition of bacterial infection in the biliary tract with a high mortality rate of around 10%. Direct association between presence of bacteremia and 30-day mortality among AC patients is sparsely investigated and remains unclear.
Our aim was to investigate association between bacteremia and 30-day mortality among patients with AC included over a period of 25 years. All AC patients that underwent endoscopic retrograde cholangiopancreatography (ERCP) at Odense University Hospital, between 1 January 1990 and 31 October 2015, were identified using a prospective ERCP database. Blood culture results from the patients along with antimicrobial resistance patterns were collected from a bacteremia research database.
During the study period, 775 consecutive AC patients underwent ERCP and blood cultures were collected from 528 patients. Among these patients 48% ( = 260) had bacteremia. Overall, 30-day mortality in patients with blood cultures performed was 13% ( = 69). In patients with bacteremia, 30-day mortality was 19% ( = 49), compared to 7% ( = 20) in patients without bacteremia ( < .01). Presence of bacteremia was associated with increased 30-day mortality (OR [95% CI]: 3.43 [1.92-6.13]; < .01) following adjustment for confounding factors. Among the species, bacteremia with Enterobacter cloacae was significantly associated with increased 30-day mortality (OR [95% CI]: 2.97 [1.16-7.62]; = .02).
Our results indicate that presence of bacteremia was associated with a nearly fourfold increase in 30-day mortality among AC patients.
急性胆管炎（AC）是一种胆道细菌感染的疾病，其死亡率约为 10%。AC 患者菌血症与 30 天死亡率之间的直接关联研究甚少，目前仍不清楚。
我们的目的是调查在过去 25 年期间接受内镜逆行胰胆管造影术（ERCP）的 AC 患者中菌血症与 30 天死亡率之间的关联。通过前瞻性的 ERCP 数据库，确定了 1990 年 1 月 1 日至 2015 年 10 月 31 日期间在奥登塞大学医院接受 ERCP 的所有 AC 患者。从菌血症研究数据库中收集了患者的血培养结果和抗生素耐药模式。
在研究期间，775 例连续的 AC 患者接受了 ERCP，其中 528 例患者采集了血培养。这些患者中有 48%（260 例）发生菌血症。总的来说，进行血培养的患者中有 30 天死亡率为 13%（69 例）。在发生菌血症的患者中，30 天死亡率为 19%（49 例），而未发生菌血症的患者中 30 天死亡率为 7%（20 例）（<.01）。在调整混杂因素后，菌血症的存在与 30 天死亡率增加相关（比值比[95%CI]：3.43[1.92-6.13]；<.01）。在各菌种中，肠杆菌科的阴沟肠杆菌菌血症与 30 天死亡率增加显著相关（比值比[95%CI]：2.97[1.16-7.62]；=0.02）。
我们的结果表明，AC 患者菌血症的存在与 30 天死亡率增加近四倍相关。
