Multifactorial Analysis of Biliary Infection in Patients with Hepato-pancreatico-biliary and Associated Intraabdominal Malignancies Admitted to a Teaching Hospital in Northern India.

Mitra Kar, Akanksha Dubey, Sangram Singh Patel, Chinmoy Sahu, Anjali Yadav
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Abstract

Background: Blockage of the biliary tract is commonly caused by malignant tumors leading to deranged liver function, responsible for poor prognosis and a high rate of bacteriobilia leading to mortality.

Material and methods: We collected retrospective data from the hospital information system and laboratory registers in our department from 2021 to 2022 to evaluate biliary infections in patients with hepato-pancreatico-biliary and associated intraabdominal malignancies.

Result: A total of 118 (118/234, 50.43%) patients' bile samples were estimated in this study. Patients' average age was 53.02 ± 13.49 years, with more patients below the age of 65 years among those with infected bile samples. Eight patients were infected by 102 pathogenic microorganisms. The most common pathogenic microorganism responsible for biliary infection in patients with abdominal malignancies was Escherichia coli (38/102, 37.25%) followed by Klebsiella pneumoniae (21/102, 20.59%) and Enterococcus spp. (18/102, 17.65%). Underlying comorbidities like diabetes mellitus, hypothyroidism, hypoproteinemia, chronic liver disease, immunosuppression, chronic kidney disease, increased hospital stay, admission to the intensive care unit (ICU), and presence of percutaneous transhepatic biliary drain were statistically significant risk factors for isolation of multidrug-resistant pathogenic bacteria.

Conclusion: Our study guided physicians in identifying the associated demographic characteristics, risk factors, and the spectrum of pathogens responsible for bacteriobilia in abdominal cancer patients along with the antibiotic resistance pattern among these isolates and better selection of antibiotics and antibiotic prophylaxis for patients at risk of developing biliary tract infections with multidrug-resistant pathogens.

How to cite this article: Kar M, Dubey A, Patel SS, et al. Multifactorial Analysis of Biliary Infection in Patients with Hepato-pancreatico-biliary and Associated Intraabdominal Malignancies Admitted to a Teaching Hospital in Northern India. Euroasian J Hepato-Gastroenterol 2023;13(1):10-17.

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印度北部一家教学医院收治的肝胰胆及相关腹腔恶性肿瘤患者胆道感染的多因素分析。
背景:胆道阻塞通常是由恶性肿瘤引起的,导致肝功能紊乱,导致预后不良,胆道感染率高导致死亡。材料和方法:我们收集了2021年至2022年我科医院信息系统和实验室登记的回顾性数据,以评估肝胰胆管和相关腹腔内恶性肿瘤患者的胆道感染。结果:本研究共估计了118例(118/234,50.43%)患者的胆汁样本。患者的平均年龄为53.02±13.49岁,在感染胆汁样本的患者中,65岁以下的患者更多。8例患者被102种病原微生物感染。导致腹部恶性肿瘤患者胆道感染的最常见病原微生物是大肠杆菌(38/102,37.25%),其次是肺炎克雷伯菌(21/102,20.59%)和肠球菌属(18/102,17.65%)。潜在的合并症如糖尿病、甲状腺功能减退、低蛋白血症、慢性肝病、免疫抑制、慢性肾脏疾病,住院时间增加、入住重症监护室(ICU)和经皮肝穿刺胆道引流是分离耐多药致病菌的统计学显著风险因素。结论:我们的研究指导医生识别相关的人口统计学特征、危险因素、,以及导致癌症患者胆汁的病原体谱,以及这些分离株之间的抗生素耐药性模式,以及更好地选择抗生素和对有多重耐药病原体发展为胆道感染风险的患者进行抗生素预防。如何引用这篇文章:Kar M,Dubey A,Patel SS等。印度北部一家教学医院收治的肝胰胆及相关腹腔恶性肿瘤患者胆道感染的多因素分析。Euroasian J Hepato-Gastroenterol 2023;13(1):10-17。
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