Suppr超能文献

对恶性肿瘤患者经皮肝穿刺胆管造影相关血流及胆道感染的评估及预防措施

Evaluation of Blood Stream and Biliary Tract Infections Related to Percutaneous Transhepatic Cholangiography and Prophylaxis Given in Patients with Malignancy.

作者信息

Araz Halime, Eren Tülay, Kocagül-Çelikbaş Aysel, Özdemir Nuriye

机构信息

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.

出版信息

Infect Dis Clin Microbiol. 2022 Dec 21;4(4):274-279. doi: 10.36519/idcm.2022.176. eCollection 2022 Dec.

Abstract

OBJECTIVE

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.

MATERIALS AND METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

材料与方法

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。

结果

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。

结论

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。

相似文献

4
Sepsis associated with transhepatic cholangiography.
J Hosp Infect. 1992 Jan;20(1):43-50. doi: 10.1016/0195-6701(92)90060-y.
7
Percutaneous transhepatic cholangiography and biliary drainage in pediatric liver transplant patients.
AJR Am J Roentgenol. 2001 Mar;176(3):761-5. doi: 10.2214/ajr.176.3.1760761.
8
Percutaneous ultrasound-guided cholangiography using microbubbles to evaluate the dilated biliary tract: initial experience.
Eur Radiol. 2012 Feb;22(2):371-8. doi: 10.1007/s00330-011-2265-5. Epub 2011 Sep 24.
9
Grey-scale ultrasonography and percutaneous transhepatic cholangiography in biliary tract disease.
Br Med J. 1980 Dec 6;281(6254):1524-6. doi: 10.1136/bmj.281.6254.1524.

本文引用的文献

1
Antibiotic resistance in the patient with cancer: Escalating challenges and paths forward.
CA Cancer J Clin. 2021 Nov;71(6):488-504. doi: 10.3322/caac.21697. Epub 2021 Sep 21.
3
Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis.
J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):3-16. doi: 10.1002/jhbp.518. Epub 2018 Jan 9.
4
Infections in Cancer Patients with Solid Tumors: A Review.
Infect Dis Ther. 2017 Mar;6(1):69-83. doi: 10.1007/s40121-017-0146-1. Epub 2017 Feb 3.
6
Malignant biliary obstructions: can we predict immediate postprocedural cholangitis after percutaneous biliary drainage?
Support Care Cancer. 2013 Aug;21(8):2321-6. doi: 10.1007/s00520-013-1796-5. Epub 2013 Mar 26.
8
Evidence-based decompression in malignant biliary obstruction.
Korean J Radiol. 2012 Jan-Feb;13 Suppl 1(Suppl 1):S56-61. doi: 10.3348/kjr.2012.13.S1.S56. Epub 2012 Apr 23.
9
Bacteribilia with resistant microorganisms after preoperative biliary drainage--the influence of bacteria on postoperative outcome.
Scand J Gastroenterol. 2012 Jul;47(7):827-35. doi: 10.3109/00365521.2012.679684. Epub 2012 Apr 17.
10
British Society of Interventional Radiology: Biliary Drainage and Stenting Registry (BDSR).
Cardiovasc Intervent Radiol. 2012 Feb;35(1):127-38. doi: 10.1007/s00270-011-0103-4. Epub 2011 Feb 8.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验