CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2018; 02(03): S4
DOI: 10.1055/s-0041-1730656
Abstract

Biliary Culture Analysis Obtained During Percutaneous Biliary Intervention: A Multicenter Analysis – Are we Treating Biliary Sepsis with the Correct Antibiotics?

Pavan Najran
The Christie Hospital NHS Foundation Trust, Manchester, UK
,
Jon Bell
The Christie Hospital NHS Foundation Trust, Manchester, UK
› Author Affiliations

Background: A multicenter retrospective analysis of the pathogens isolated from biliary cultures in patients treated with percutaneous transhepatic intervention. To assess of the pathogen profile and antibiotic sensitivity to decipher the most appropriate treatment regimen. Methods: All percutaneous transhepatic interventions performed over a 2-year period in three separate centers were reviewed retrospectively. Those where no biliary culture was obtained were excluded from the study. Analysis of the culture results including pathogens grown and antibiotic sensitivity was performed. Results: A total of 104 patients were included in the analysis, 58 from center 1, 13 from center 2, and 33 from center 3. No pathogens were grown in 15.3% of cultures (n = 16). Of those with positive cultures (n = 88), enterococci and Pseudomonas were the most common pathogens grown in 52.3% of cases (n = 46). Ciprofloxacin and vancomycin were equally the most sensitive antimicrobials demonstrating sensitivity in 27.3% (n = 24) of positive cultures. Gentamycin was the fifth most sensitive antimicrobial demonstrating sensitivity in 20.5% (n = 18). Conclusion: Over the three centers included in the analysis, there is no common antimicrobial administered before percutaneous biliary intervention. In center 1, gentamycin is administered prophylactically; this study has demonstrated that this is comparably ineffective with low sensitivity and high resistance requiring a change in protocol. Effective antibiotic prophylaxis requires knowledge of likely pathogens and procedure-specific infection risks. However, the choice of antimicrobial is dynamic given the ability of antibiotic resistance to eliminate historically effective regimens.



Publication History

Article published online:
11 May 2021

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