Ming Tan1,2, Thøger Gorm Jensen2,3, Stig Lønberg Nielsen2,4, Ove B Schaffalitzky de Muckadell1,2, Stig Borbjerg Laursen1,2. 1. Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark. 2. Department of Clinical Research, University of Southern Denmark, Odense, Denmark. 3. Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark. 4. Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.
Abstract
INTRODUCTION: Acute cholangitis (AC) is a condition of bacterial infection in the biliary tract with a high mortality rate of around 10%. Direct association between presence of bacteremia and 30-day mortality among AC patients is sparsely investigated and remains unclear. AIMS AND METHODS: Our aim was to investigate association between bacteremia and 30-day mortality among patients with AC included over a period of 25 years. All AC patients that underwent endoscopic retrograde cholangiopancreatography (ERCP) at Odense University Hospital, between 1 January 1990 and 31 October 2015, were identified using a prospective ERCP database. Blood culture results from the patients along with antimicrobial resistance patterns were collected from a bacteremia research database. RESULTS: During the study period, 775 consecutive AC patients underwent ERCP and blood cultures were collected from 528 patients. Among these patients 48% (n = 260) had bacteremia. Overall, 30-day mortality in patients with blood cultures performed was 13% (n = 69). In patients with bacteremia, 30-day mortality was 19% (n = 49), compared to 7% (n = 20) in patients without bacteremia (p < .01). Presence of bacteremia was associated with increased 30-day mortality (OR [95% CI]: 3.43 [1.92-6.13]; p < .01) following adjustment for confounding factors. Among the species, bacteremia with Enterobacter cloacae was significantly associated with increased 30-day mortality (OR [95% CI]: 2.97 [1.16-7.62]; p = .02). CONCLUSION: Our results indicate that presence of bacteremia was associated with a nearly fourfold increase in 30-day mortality among AC patients.
INTRODUCTION: Acute cholangitis (AC) is a condition of bacterial infection in the biliary tract with a high mortality rate of around 10%. Direct association between presence of bacteremia and 30-day mortality among AC patients is sparsely investigated and remains unclear. AIMS AND METHODS: Our aim was to investigate association between bacteremia and 30-day mortality among patients with AC included over a period of 25 years. All AC patients that underwent endoscopic retrograde cholangiopancreatography (ERCP) at Odense University Hospital, between 1 January 1990 and 31 October 2015, were identified using a prospective ERCP database. Blood culture results from the patients along with antimicrobial resistance patterns were collected from a bacteremia research database. RESULTS: During the study period, 775 consecutive AC patients underwent ERCP and blood cultures were collected from 528 patients. Among these patients 48% (n = 260) had bacteremia. Overall, 30-day mortality in patients with blood cultures performed was 13% (n = 69). In patients with bacteremia, 30-day mortality was 19% (n = 49), compared to 7% (n = 20) in patients without bacteremia (p < .01). Presence of bacteremia was associated with increased 30-day mortality (OR [95% CI]: 3.43 [1.92-6.13]; p < .01) following adjustment for confounding factors. Among the species, bacteremia with Enterobacter cloacae was significantly associated with increased 30-day mortality (OR [95% CI]: 2.97 [1.16-7.62]; p = .02). CONCLUSION: Our results indicate that presence of bacteremia was associated with a nearly fourfold increase in 30-day mortality among AC patients.
Authors: Marco Mussa; Pedro María Martínez Pérez-Crespo; Luis Eduardo Lopez-Cortes; Pilar Retamar-Gentil; Adrián Sousa-Dominguez; Ane Josune Goikoetxea-Aguirre; José María Reguera-Iglesias; Eva León Jiménez; Isabel Fernández-Natal; Carlos Armiñanzas-Castillo; Lucía Boix-Palop; Jordi Cuquet-Pedragosa; Miguel Ángel Morán Rodríguez; Jonathan Fernandez-Suarez; Alfonso Del Arco-Jiménez; Alfredo Jóver-Saenz; Alberto Bahamonde-Carrasco; Fátima Galan-Sanchez; Juan Manuel Sánchez-Calvo; Alejandro Smithson-Amat; David Vinuesa-García; Antonio Sánchez-Porto; Inmaculada López-Hernández; Jesús Rodríguez-Baño Journal: Microbiol Spectr Date: 2022-06-30