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The Impact of Bile Duct Cultures on Surgical Site Infections in Pancreatic Surgery
- Source :
- Surgical Infections. 16:443-449
- Publication Year :
- 2015
- Publisher :
- Mary Ann Liebert Inc, 2015.
-
Abstract
- In pancreatic surgery pre-operative biliary drainage (PBD) is associated with bacteribilia, which increases the risk for surgical site infections (SSIs).This study is a retrospective observational cohort design that compared micro-organisms of intra-operative bile duct cultures with micro-organisms of SSIs after pancreaticoduodenectomy.From January 2004 until December 2010, 887 patients underwent pancreaticoduodenectomy or hepaticojejunostomy for benign and malignant peri-ampullary lesions. Surgical site infections occurred in 10% (87/887). Cultures of SSIs with corresponding intra-operative bile duct cultures were available for 59 patients. Sixty-four percent (38/59) had undergone PBD. Pre-operative biliary drainage was associated with positive intra-operative bile duct cultures in 95% (36/38), versus 48% (10/21; p≤0.001). The correlation of SSIs with intra-operative bile duct cultures was 59% (35/59). There was a significant association between the micro-organisms cultured from SSIs and the corresponding bile duct cultures for Enterococcus spp., Escherichia coli, Klebsiella pneumoniae, methicillin-resistant Staphylococcus aureus (MRSA), Enterobacteriaceae with extended spectrum ß-lactamase (ESBL), and Candida spp.After pancreaticoduodenectomy, SSIs are often caused by the same micro-organisms that are present on intra-operative bile duct cultures, especially after PBD. Therefore, intra-operative bile duct cultures should be performed routinely to adjust the antibiotic prophylaxis according to the local hospital surveillance data.
- Subjects :
- Male
Microbiology (medical)
medicine.medical_specialty
medicine.medical_treatment
Gastroenterology
Pancreaticoduodenectomy
Pancreatic surgery
Internal medicine
Surgical site
medicine
Humans
Surgical Wound Infection
Aged
Analysis of Variance
Biliary drainage
Bacteria
business.industry
Bile duct
Candidiasis
Bacterial Infections
Middle Aged
Surgery
Infectious Diseases
medicine.anatomical_structure
Female
Bile Ducts
business
Cohort study
Subjects
Details
- ISSN :
- 15578674 and 10962964
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- Surgical Infections
- Accession number :
- edsair.doi.dedup.....d295a798d6673f790a13d3c07a28b704