Different Biliary Microbial Flora Influence Type of Complications after Pancreaticoduodenectomy: A Single Center Retrospective Analysis
Background: Bacterobilia is associated with postoperative morbidity after pancreaticoduodenectomy (PD), mostly due to infectious complications. The aim of this study was to investigate the prevalence of bacteria species isolated from intraoperative biliary cultures, and related complications after P...
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| Language: | English |
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MDPI AG
2021-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/10/2180 |
| _version_ | 1797533674650992640 |
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| author | Alessandro Coppola Vincenzo La Vaccara Tommaso Farolfi Michele Fiore Chiara Cascone Sara Ramella Silvia Spoto Massimo Ciccozzi Silvia Angeletti Roberto Coppola Damiano Caputo |
| author_facet | Alessandro Coppola Vincenzo La Vaccara Tommaso Farolfi Michele Fiore Chiara Cascone Sara Ramella Silvia Spoto Massimo Ciccozzi Silvia Angeletti Roberto Coppola Damiano Caputo |
| author_sort | Alessandro Coppola |
| collection | DOAJ |
| description | Background: Bacterobilia is associated with postoperative morbidity after pancreaticoduodenectomy (PD), mostly due to infectious complications. The aim of this study was to investigate the prevalence of bacteria species isolated from intraoperative biliary cultures, and related complications after PD. Methods: An ANOVA test was used to assess the prevalence of isolated bacterial species and postoperative complications. The odds ratio was computed to evaluate the association between biliary cultures and each complication, Endoscopic Retrograde CholangioPancreatography (ERCP) and each complication, ERCP and biliary cultures, Delayed Gastric Emptying (DGE) and Postoperative Pancreatic Fistula (POPF). Results: Positive biliary cultures were found in 162/244 (66%) PDs. Different prevalences of polymicrobial biliary culture were detected in patients with postoperative complications. In SSIs, a significant prevalence of biliary culture positive for <i>E. coli</i>, <i>Klebsiella pneumoniæ</i> and <i>Enterococcus fæcalis</i> (<i>p</i> < 0.001) was detected. Prevalences of polymicrobial biliary cultures with <i>Escherichia coli</i>, <i>Klebsiella pneumoniæ</i>, <i>Enterococcus fæcalis</i> and <i>Enterococcus fæcium</i> were significantly associated with POPF (<i>p</i> < 0.001). Biliary culture positive for <i>Escherichia coli</i>, <i>Enterococcus fæcalis</i> and <i>Enterococcus fæcium</i> showed a higher prevalence of intra-abdominal collection and DGE (<i>p</i> < 0.001). Notably, <i>Escherichia coli</i> was significantly associated with DGE as a unique complication (OR = 2.94 (1.30–6.70); <i>p</i> < 0.01). Conclusions: Specific prevalences of polymicrobial bacterobilia are associated with major complications, while monomicrobial <i>Escherichia coli</i> bacterobilia is associated with DGE as a unique complication after PD. |
| first_indexed | 2024-03-10T11:18:00Z |
| format | Article |
| id | doaj.art-4c671c4abec641a0a185a8c3f76d5056 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T11:18:00Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-4c671c4abec641a0a185a8c3f76d50562023-11-21T20:14:42ZengMDPI AGJournal of Clinical Medicine2077-03832021-05-011010218010.3390/jcm10102180Different Biliary Microbial Flora Influence Type of Complications after Pancreaticoduodenectomy: A Single Center Retrospective AnalysisAlessandro Coppola0Vincenzo La Vaccara1Tommaso Farolfi2Michele Fiore3Chiara Cascone4Sara Ramella5Silvia Spoto6Massimo Ciccozzi7Silvia Angeletti8Roberto Coppola9Damiano Caputo10Department of Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, ItalyDepartment of Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, ItalyDepartment of Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, ItalyRadiation Oncology, Università Campus Bio-Medico di Roma, 00128 Rome, ItalyDepartment of Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, ItalyRadiation Oncology, Università Campus Bio-Medico di Roma, 00128 Rome, ItalyDiagnostic and Therapeutic Medicine Department, Università Campus Bio-Medico di Roma, 00128 Rome, ItalyUnit of Medical Statistic and Molecular Epidemiology, Università Campus Bio-Medico di Roma, 00128 Rome, ItalyUnit of Clinical Laboratory Science, Università Campus Bio-Medico di Roma, 00128 Rome, ItalyDepartment of Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, ItalyDepartment of Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, ItalyBackground: Bacterobilia is associated with postoperative morbidity after pancreaticoduodenectomy (PD), mostly due to infectious complications. The aim of this study was to investigate the prevalence of bacteria species isolated from intraoperative biliary cultures, and related complications after PD. Methods: An ANOVA test was used to assess the prevalence of isolated bacterial species and postoperative complications. The odds ratio was computed to evaluate the association between biliary cultures and each complication, Endoscopic Retrograde CholangioPancreatography (ERCP) and each complication, ERCP and biliary cultures, Delayed Gastric Emptying (DGE) and Postoperative Pancreatic Fistula (POPF). Results: Positive biliary cultures were found in 162/244 (66%) PDs. Different prevalences of polymicrobial biliary culture were detected in patients with postoperative complications. In SSIs, a significant prevalence of biliary culture positive for <i>E. coli</i>, <i>Klebsiella pneumoniæ</i> and <i>Enterococcus fæcalis</i> (<i>p</i> < 0.001) was detected. Prevalences of polymicrobial biliary cultures with <i>Escherichia coli</i>, <i>Klebsiella pneumoniæ</i>, <i>Enterococcus fæcalis</i> and <i>Enterococcus fæcium</i> were significantly associated with POPF (<i>p</i> < 0.001). Biliary culture positive for <i>Escherichia coli</i>, <i>Enterococcus fæcalis</i> and <i>Enterococcus fæcium</i> showed a higher prevalence of intra-abdominal collection and DGE (<i>p</i> < 0.001). Notably, <i>Escherichia coli</i> was significantly associated with DGE as a unique complication (OR = 2.94 (1.30–6.70); <i>p</i> < 0.01). Conclusions: Specific prevalences of polymicrobial bacterobilia are associated with major complications, while monomicrobial <i>Escherichia coli</i> bacterobilia is associated with DGE as a unique complication after PD.https://www.mdpi.com/2077-0383/10/10/2180bacterobiliapancreaticoduodenectomy<i>E. coli</i>pancreatic fistulaDGEERCP |
| spellingShingle | Alessandro Coppola Vincenzo La Vaccara Tommaso Farolfi Michele Fiore Chiara Cascone Sara Ramella Silvia Spoto Massimo Ciccozzi Silvia Angeletti Roberto Coppola Damiano Caputo Different Biliary Microbial Flora Influence Type of Complications after Pancreaticoduodenectomy: A Single Center Retrospective Analysis Journal of Clinical Medicine bacterobilia pancreaticoduodenectomy <i>E. coli</i> pancreatic fistula DGE ERCP |
| title | Different Biliary Microbial Flora Influence Type of Complications after Pancreaticoduodenectomy: A Single Center Retrospective Analysis |
| title_full | Different Biliary Microbial Flora Influence Type of Complications after Pancreaticoduodenectomy: A Single Center Retrospective Analysis |
| title_fullStr | Different Biliary Microbial Flora Influence Type of Complications after Pancreaticoduodenectomy: A Single Center Retrospective Analysis |
| title_full_unstemmed | Different Biliary Microbial Flora Influence Type of Complications after Pancreaticoduodenectomy: A Single Center Retrospective Analysis |
| title_short | Different Biliary Microbial Flora Influence Type of Complications after Pancreaticoduodenectomy: A Single Center Retrospective Analysis |
| title_sort | different biliary microbial flora influence type of complications after pancreaticoduodenectomy a single center retrospective analysis |
| topic | bacterobilia pancreaticoduodenectomy <i>E. coli</i> pancreatic fistula DGE ERCP |
| url | https://www.mdpi.com/2077-0383/10/10/2180 |
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