Incidence of Cholangitis and Sepsis Associated with Percutaneous Transhepatic Cholangiography in Pediatric Liver Transplant Recipients
<b>Background.</b> Percutaneous transhepatic cholangiography (PTC) is an established treatment in the management of biliary strictures. The aim of our study was to determine the incidence of PTC-related infectious complications in transplanted children, and identify their precise aetiol-...
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MDPI AG
2021-03-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/10/3/282 |
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| author | Naire Sansotta Ester De Luca Emanuele Nicastro Alessandra Tebaldi Alberto Ferrari Lorenzo D’Antiga |
| author_facet | Naire Sansotta Ester De Luca Emanuele Nicastro Alessandra Tebaldi Alberto Ferrari Lorenzo D’Antiga |
| author_sort | Naire Sansotta |
| collection | DOAJ |
| description | <b>Background.</b> Percutaneous transhepatic cholangiography (PTC) is an established treatment in the management of biliary strictures. The aim of our study was to determine the incidence of PTC-related infectious complications in transplanted children, and identify their precise aetiol-ogy. <b>Methods.</b> We retrospectively reviewed all PTC performed from January 2017 to October 2020 in our center. Before the procedure, all patients received antibiotic prophylaxis defined as first line, while second line was used in case of previously microbiological isolation. Cholangitis was defined as fever (>38.5°) and elevated inflammatory markers after PTC, while sepsis included hemodynamic instability in addition to cholangitis. <b>Results.</b> One hundred and fifty-seven PTCs from 50 pediatric recipients were included. The overall incidence of cholangitis and sepsis after PTC was 44.6% (70/157) and 3.2% (5/157), respectively, with no fatal events. Blood cultures yielded positive results in 15/70 cases (21.4%). <i>Enterococcus faecium and Pseudomonas aeruginosa</i> were the most common isolated pathogens. Multidrug-resistant (MDR) pathogens were found in 11/50 patients (22%). <b>Conclusion.</b> PTC is associated with a relatively high rate of post-procedural cholangitis, although with low rate of sepsis and no fatal events. Blood cultures allowed to find a precise aetiology in roughly a quarter of the cases, showing prevalence of <i>Enterococcus faecium and Pseudomonas aeruginosa</i>. |
| first_indexed | 2024-03-10T13:23:25Z |
| format | Article |
| id | doaj.art-9fd192bfccef4684817404923071ff93 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T13:23:25Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-9fd192bfccef4684817404923071ff932023-11-21T09:50:19ZengMDPI AGAntibiotics2079-63822021-03-0110328210.3390/antibiotics10030282Incidence of Cholangitis and Sepsis Associated with Percutaneous Transhepatic Cholangiography in Pediatric Liver Transplant RecipientsNaire Sansotta0Ester De Luca1Emanuele Nicastro2Alessandra Tebaldi3Alberto Ferrari4Lorenzo D’Antiga5Paediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, 24127 Bergamo, ItalyDepartment of Pediatrics, University of Milano Bicocca, 20126 Milan, ItalyPaediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, 24127 Bergamo, ItalyInfectious Diseases Unit, Hospital Papa Giovanni XXIII, 24127 Bergamo, ItalyFROM Research Foundation, Statistics, Hospital Papa Giovanni XXIII, 24127 Bergamo, ItalyPaediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy<b>Background.</b> Percutaneous transhepatic cholangiography (PTC) is an established treatment in the management of biliary strictures. The aim of our study was to determine the incidence of PTC-related infectious complications in transplanted children, and identify their precise aetiol-ogy. <b>Methods.</b> We retrospectively reviewed all PTC performed from January 2017 to October 2020 in our center. Before the procedure, all patients received antibiotic prophylaxis defined as first line, while second line was used in case of previously microbiological isolation. Cholangitis was defined as fever (>38.5°) and elevated inflammatory markers after PTC, while sepsis included hemodynamic instability in addition to cholangitis. <b>Results.</b> One hundred and fifty-seven PTCs from 50 pediatric recipients were included. The overall incidence of cholangitis and sepsis after PTC was 44.6% (70/157) and 3.2% (5/157), respectively, with no fatal events. Blood cultures yielded positive results in 15/70 cases (21.4%). <i>Enterococcus faecium and Pseudomonas aeruginosa</i> were the most common isolated pathogens. Multidrug-resistant (MDR) pathogens were found in 11/50 patients (22%). <b>Conclusion.</b> PTC is associated with a relatively high rate of post-procedural cholangitis, although with low rate of sepsis and no fatal events. Blood cultures allowed to find a precise aetiology in roughly a quarter of the cases, showing prevalence of <i>Enterococcus faecium and Pseudomonas aeruginosa</i>.https://www.mdpi.com/2079-6382/10/3/282childrenliver transplantcholangiography |
| spellingShingle | Naire Sansotta Ester De Luca Emanuele Nicastro Alessandra Tebaldi Alberto Ferrari Lorenzo D’Antiga Incidence of Cholangitis and Sepsis Associated with Percutaneous Transhepatic Cholangiography in Pediatric Liver Transplant Recipients Antibiotics children liver transplant cholangiography |
| title | Incidence of Cholangitis and Sepsis Associated with Percutaneous Transhepatic Cholangiography in Pediatric Liver Transplant Recipients |
| title_full | Incidence of Cholangitis and Sepsis Associated with Percutaneous Transhepatic Cholangiography in Pediatric Liver Transplant Recipients |
| title_fullStr | Incidence of Cholangitis and Sepsis Associated with Percutaneous Transhepatic Cholangiography in Pediatric Liver Transplant Recipients |
| title_full_unstemmed | Incidence of Cholangitis and Sepsis Associated with Percutaneous Transhepatic Cholangiography in Pediatric Liver Transplant Recipients |
| title_short | Incidence of Cholangitis and Sepsis Associated with Percutaneous Transhepatic Cholangiography in Pediatric Liver Transplant Recipients |
| title_sort | incidence of cholangitis and sepsis associated with percutaneous transhepatic cholangiography in pediatric liver transplant recipients |
| topic | children liver transplant cholangiography |
| url | https://www.mdpi.com/2079-6382/10/3/282 |
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