Characteristics of biliary bacterial colonization and bacteremia following endoscopic retrograde cholangiopancreatography
Gazi Medical Journal, cilt.15, sa.2, ss.37-43, 2004 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 15 Sayı: 2
- Basım Tarihi: 2004
- Dergi Adı: Gazi Medical Journal
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.37-43
- Anahtar Kelimeler: Bacteremia, Biliary Infection, ERCP
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose: Biliary infection and septicemia are probable fatal complications of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy that may compromise their benefits. The aim of this study was to investigate which patients are more susceptible to the infectious complications following ERCP in a specific era, and to identify the type of pathogens involved and the appropriate antibiotics for these microorganisms. Methods: Bile (during ERCP) and blood samples (before and right after ERCP) were obtained in 37 patients (21 females, 16 males, mean age 54) and cultured for aerobic and anaerobic bacteria. The pathogens identified, the antibiograms obtained, and the relationship of the type of endoscopic procedure and the final diagnosis with the type of infectious complication were evaluated. Results: Biliary bacterial colonization was observed in 28 (76%) patients. The majority of the identified microorganisms were Gram-negative bacilli. Biliary bacterial colonization were seen more frequently in therapeutic ERCP patients (n: 24) than in diagnostic ERCP patients (n: 13) (p<0.05). Bacteremia was observed in 7 cases, with no significant difference between diagnostic and therapeutic ERCP patients. Biliary bacterial colonization was more frequent in patients with abnormal ERCP findings than in those with normal ERCP (p<0.05). Bacteremia was also significantly more frequent in patients with biliary obstruction (p<0.05). Conclusion: Infectious complications are more likely to occur in patients with biliary obstruction and in those who undergo therapeutic ERCP procedures. The vast majority of the pathogens (most of them were Gram-negative bacilli) identified are susceptible to ciprofloxacin, ofloxacin and imipenem. We think that appropriate use of prophylactic antibiotics in ERCP can reduce the rate of infectious complications, especially in patients with a high risk.