急性胆管炎患者血培养病原菌的微生物学特征:来自胆肠吻合患者的见解。

IF 2.8 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Yuta Kuhara, Hiroki Kitagawa, Yuki Kaiki, Keitaro Omori, Norifumi Shigemoto, Tomoyuki Akita, Kenichiro Uemura, Shingo Fukuma, Shinya Takahashi, Hiroki Ohge
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引用次数: 0

摘要

背景:研究急性胆管炎(AC)患者经胆肠吻合术及胆道干预治疗(BI)后血培养物(bc)病原菌的微生物学特征。方法:回顾性分析广岛大学医院2015 ~ 2024年收治的366例AC合并菌血症患者。患者分为三组:胆道重建相关AC (PBR-AC), bi相关AC (BI-AC)和普通AC (C-AC)。统计分析各组患者的临床及微生物学资料。结果:分离最多的病原菌为大肠埃希菌和克雷伯氏菌,占各组分离菌总数的50%。与C-AC相比,ESCPM(肠杆菌,包括产气克雷伯氏菌、粘质沙雷氏菌、弗氏柠檬酸杆菌复合体、普罗维登氏菌和摩根氏菌)与PBR-和BI-AC显著相关。各组间厌氧菌患病率无显著差异。结论:PBR-和BI-AC组bc分离ESCPM的流行率明显高于C-AC组。在确定AC的治疗策略时,应检查是否存在胆肠吻合或BI病史。对于PBR和BI-AC,特别是在严重病例中,头孢吡肟可能是更好的抗生素选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Microbiological Characteristics of Pathogens Isolated From Blood Cultures of Patients With Acute Cholangitis: Insights From Patients With Biliary-Enteric Anastomosis.

Background: We aimed to investigate the microbiological characteristics of pathogens isolated from blood cultures (BCs) of patients with acute cholangitis (AC) after biliary-enteric anastomosis and biliary intervention (BI).

Methods: A retrospective analysis was conducted on 366 patients with AC and bacteremia between 2015 and 2024 at Hiroshima University Hospital. Patients were categorized into three groups: post-biliary reconstruction-associated AC (PBR-AC), BI-associated AC (BI-AC), and common AC (C-AC). Patients' clinical and microbiological data were statistically analyzed in each group.

Results: The most frequently isolated pathogens were Escherichia coli and Klebsiella spp., accounting for > 50% of isolates in all groups. ESCPM spp. (Enterobacter spp., including Klebsiella aerogenes, Serratia marcescens, Citrobacter freundii complex, Providencia spp., and Morganella morganii) were significantly associated with PBR- and BI-AC compared with C-AC. No significant differences in the prevalence of anaerobic bacteria were observed among the groups.

Conclusions: The prevalence of ESCPM spp. isolated from BCs was significantly higher in the PBR- and BI-AC groups than in the C-AC group. The presence of biliary-enteric anastomosis or BI history should be checked when determining the treatment strategy for AC. Cefepime may be a better antibiotic option for PBR- and BI-AC, particularly in severe cases.

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来源期刊
Journal of Hepato‐Biliary‐Pancreatic Sciences
Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY
自引率
10.00%
发文量
178
审稿时长
6-12 weeks
期刊介绍: The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
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