Sansotta Naire, De Luca Ester, Nicastro Emanuele, Tebaldi Alessandra, Ferrari Alberto, D'Antiga Lorenzo
Paediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy.
Department of Pediatrics, University of Milano Bicocca, 20126 Milan, Italy.
Antibiotics (Basel). 2021 Mar 10;10(3):282. doi: 10.3390/antibiotics10030282.
Percutaneous transhepatic cholangiography (PTC) is an established treatment in the management of biliary strictures. The aim of our study was to determine the incidence of PTC-related infectious complications in transplanted children, and identify their precise aetiol-ogy. We retrospectively reviewed all PTC performed from January 2017 to October 2020 in our center. Before the procedure, all patients received antibiotic prophylaxis defined as first line, while second line was used in case of previously microbiological isolation. Cholangitis was defined as fever (>38.5°) and elevated inflammatory markers after PTC, while sepsis included hemodynamic instability in addition to cholangitis. One hundred and fifty-seven PTCs from 50 pediatric recipients were included. The overall incidence of cholangitis and sepsis after PTC was 44.6% (70/157) and 3.2% (5/157), respectively, with no fatal events. Blood cultures yielded positive results in 15/70 cases (21.4%). were the most common isolated pathogens. Multidrug-resistant (MDR) pathogens were found in 11/50 patients (22%). PTC is associated with a relatively high rate of post-procedural cholangitis, although with low rate of sepsis and no fatal events. Blood cultures allowed to find a precise aetiology in roughly a quarter of the cases, showing prevalence of .
经皮经肝胆道造影术（PTC）是治疗胆道狭窄的一种成熟方法。我们研究的目的是确定移植儿童中PTC相关感染并发症的发生率，并明确其确切病因。我们回顾性分析了2017年1月至2020年10月在本中心进行的所有PTC。术前，所有患者均接受一线抗生素预防，若先前有微生物分离情况则使用二线预防。胆管炎定义为PTC后发热（>38.5°）且炎症标志物升高，而脓毒症除胆管炎外还包括血流动力学不稳定。纳入了50名儿科受者的157次PTC。PTC后胆管炎和脓毒症的总体发生率分别为44.6%（70/157）和3.2%（5/157），无死亡事件。70例中有15例（21.4%）血培养结果呈阳性。 是最常见的分离病原体。50例患者中有11例（22%）发现多重耐药（MDR）病原体。PTC术后胆管炎发生率相对较高，尽管脓毒症发生率较低且无死亡事件。血培养在大约四分之一的病例中能找到确切病因，显示 患病率较高。
