Araz Halime, Eren Tülay, Kocagül-Çelikbaş Aysel, Özdemir Nuriye
Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.
Department of Medical Oncology, Health Sciences University Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara.
Infect Dis Clin Microbiol. 2022 Dec 21;4(4):274-279. doi: 10.36519/idcm.2022.176. eCollection 2022 Dec.
Percutaneous transhepatic cholangiography (PTC) is an invasive procedure used in patients with obstructive jaundice in the progress of some malignancies, and its most common complication is infection. We aimed to evaluate the patients who underwent PTC regarding their cultures, prophylaxis, and antibiotics used for treatment.
In this cross-sectional study, patients who underwent PTC and were followed up in a medical oncology outpatient clinic between 2010-2017 were evaluated retrospectively. Patients' data were obtained from the hospital record system (FONET), epicrisis forms, and patient progress files.
A total of 93 patients were included in the study. Prophylaxis was given in 50% of the cases. Complications developed in 68% of the cases after the intervention, and the infectious disease clinic consulted all. Blood cultures were obtained from 89% of the febrile patients; however, bile cultures were obtained only from 29%. The rate of resistant Gram-negative enteric bacteria in growing microorganisms was 52% (n=13). It was determined that 65% of the initiated empirical treatments were appropriate for the growth of microorganisms.
The growth rate was significantly higher in blood cultures than in bile cultures. The lower growth rate in bile culture was attributed to the low number of bile cultures. There was no significant difference regarding the growth rate and drug resistance of the microorganisms. Therefore, we think giving antibiotics as treatment rather than prophylaxis is more appropriate. Taking cultures will ensure that patients receive appropriate antibiotic therapy for the causative agent.
经皮肝穿刺胆管造影术(PTC)是用于某些恶性肿瘤进展期梗阻性黄疸患者的一种侵入性操作,其最常见的并发症是感染。我们旨在评估接受PTC治疗的患者的培养情况、预防措施以及用于治疗的抗生素。
在这项横断面研究中,对2010年至2017年间在肿瘤内科门诊接受PTC并接受随访的患者进行回顾性评估。患者数据来自医院记录系统(FONET)、病历表格和患者病程档案。
共有93例患者纳入研究。50%的病例给予了预防措施。干预后68%的病例出现并发症,所有病例均咨询了传染病科。89%的发热患者进行了血培养;然而,仅29%的患者进行了胆汁培养。培养出的微生物中革兰氏阴性肠道耐药菌的比例为52%(n = 13)。确定65%开始的经验性治疗与微生物生长情况相符。
血培养的阳性率显著高于胆汁培养。胆汁培养阳性率较低归因于胆汁培养数量较少。微生物的生长率和耐药性方面无显著差异。因此,我们认为给予抗生素进行治疗而非预防更为合适。进行培养将确保患者针对病原体接受适当的抗生素治疗。