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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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Autores principales: Coppola, Alessandro, La Vaccara, Vincenzo, Farolfi, Tommaso, Fiore, Michele, Cascone, Chiara, Ramella, Sara, Spoto, Silvia, Ciccozzi, Massimo, Angeletti, Silvia, Coppola, Roberto, Caputo, Damiano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8157867/
https://www.ncbi.nlm.nih.gov/pubmed/34070003
http://dx.doi.org/10.3390/jcm10102180
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author Coppola, Alessandro
La Vaccara, Vincenzo
Farolfi, Tommaso
Fiore, Michele
Cascone, Chiara
Ramella, Sara
Spoto, Silvia
Ciccozzi, Massimo
Angeletti, Silvia
Coppola, Roberto
Caputo, Damiano
author_facet Coppola, Alessandro
La Vaccara, Vincenzo
Farolfi, Tommaso
Fiore, Michele
Cascone, Chiara
Ramella, Sara
Spoto, Silvia
Ciccozzi, Massimo
Angeletti, Silvia
Coppola, Roberto
Caputo, Damiano
author_sort Coppola, Alessandro
collection PubMed
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 E. coli, Klebsiella pneumoniæ and Enterococcus fæcalis (p < 0.001) was detected. Prevalences of polymicrobial biliary cultures with Escherichia coli, Klebsiella pneumoniæ, Enterococcus fæcalis and Enterococcus fæcium were significantly associated with POPF (p < 0.001). Biliary culture positive for Escherichia coli, Enterococcus fæcalis and Enterococcus fæcium showed a higher prevalence of intra-abdominal collection and DGE (p < 0.001). Notably, Escherichia coli was significantly associated with DGE as a unique complication (OR = 2.94 (1.30–6.70); p < 0.01). Conclusions: Specific prevalences of polymicrobial bacterobilia are associated with major complications, while monomicrobial Escherichia coli bacterobilia is associated with DGE as a unique complication after PD.
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spelling pubmed-81578672021-05-28 Different Biliary Microbial Flora Influence Type of Complications after Pancreaticoduodenectomy: A Single Center Retrospective Analysis Coppola, Alessandro La Vaccara, Vincenzo Farolfi, Tommaso Fiore, Michele Cascone, Chiara Ramella, Sara Spoto, Silvia Ciccozzi, Massimo Angeletti, Silvia Coppola, Roberto Caputo, Damiano J Clin Med Article 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 E. coli, Klebsiella pneumoniæ and Enterococcus fæcalis (p < 0.001) was detected. Prevalences of polymicrobial biliary cultures with Escherichia coli, Klebsiella pneumoniæ, Enterococcus fæcalis and Enterococcus fæcium were significantly associated with POPF (p < 0.001). Biliary culture positive for Escherichia coli, Enterococcus fæcalis and Enterococcus fæcium showed a higher prevalence of intra-abdominal collection and DGE (p < 0.001). Notably, Escherichia coli was significantly associated with DGE as a unique complication (OR = 2.94 (1.30–6.70); p < 0.01). Conclusions: Specific prevalences of polymicrobial bacterobilia are associated with major complications, while monomicrobial Escherichia coli bacterobilia is associated with DGE as a unique complication after PD. MDPI 2021-05-18 /pmc/articles/PMC8157867/ /pubmed/34070003 http://dx.doi.org/10.3390/jcm10102180 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Coppola, Alessandro
La Vaccara, Vincenzo
Farolfi, Tommaso
Fiore, Michele
Cascone, Chiara
Ramella, Sara
Spoto, Silvia
Ciccozzi, Massimo
Angeletti, Silvia
Coppola, Roberto
Caputo, Damiano
Different Biliary Microbial Flora Influence Type of Complications after Pancreaticoduodenectomy: A Single Center Retrospective Analysis
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8157867/
https://www.ncbi.nlm.nih.gov/pubmed/34070003
http://dx.doi.org/10.3390/jcm10102180
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