{"title":"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。","authors":"Yuta Kuhara, Hiroki Kitagawa, Yuki Kaiki, Keitaro Omori, Norifumi Shigemoto, Tomoyuki Akita, Kenichiro Uemura, Shingo Fukuma, Shinya Takahashi, Hiroki Ohge","doi":"10.1002/jhbp.12193","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Microbiological Characteristics of Pathogens Isolated From Blood Cultures of Patients With Acute Cholangitis: Insights From Patients With Biliary-Enteric Anastomosis.\",\"authors\":\"Yuta Kuhara, Hiroki Kitagawa, Yuki Kaiki, Keitaro Omori, Norifumi Shigemoto, Tomoyuki Akita, Kenichiro Uemura, Shingo Fukuma, Shinya Takahashi, Hiroki Ohge\",\"doi\":\"10.1002/jhbp.12193\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":16056,\"journal\":{\"name\":\"Journal of Hepato‐Biliary‐Pancreatic Sciences\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-08-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hepato‐Biliary‐Pancreatic Sciences\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jhbp.12193\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hepato‐Biliary‐Pancreatic Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jhbp.12193","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
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.
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.