Risk Factors for Acute Cholangitis Caused by Enterococcus faecalis and Enterococcus faecium
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Background/Aims: Acute cholangitis (AC) is a potentially life-threatening bacterial infection, and timely antimicrobial treatment, faster than that achieved with bacterial cultures, is recommended. Although the current guidelines refer to empirical antimicrobial treatment, various kinds of antimicrobial agents have been cited because of insufficient analyses on the spectrum of pathogens in AC. Enterococcus spp. is one of the most frequently isolated Gram-positive bacteria from the bile of patients with AC, but its risk factors have not been extensively studied. This study aimed to analyze the risk factors of AC caused by Enterococcus faecalis and Enterococcus faecium. Methods: Patients with AC who were hospitalized in a Japanese tertiary center between 2010 and 2015 were retrospectively analyzed. Patients’ first AC episodes in the hospital were evaluated. Results: A total of 266 patients with AC were identified. E. faecalis and/or E. faecium was isolated in 56 (21%) episodes of AC. Prior endoscopic sphincterotomy (EST), the presence of a biliary stent, prior cholecystectomy, and past intensive care unit admission were more frequently observed in AC patients with E. faecalis and/or E. faecium than in those without such bacteria. Prior EST was identified as an independent risk factor for AC caused by E. faecalis and/or E. faecium in the multivariate analysis. Conclusions: Given the intrinsic resistance of E. faecalis and E. faecium to antibiotics, clinicians should consider empirical therapy with anti-enterococcal antibiotics for patients with prior EST.
Abstract
Background/Aims: Acute cholangitis (AC) is a potentially life-threatening bacterial infection, and timely antimicrobial treatment, faster than that achieved with bacterial cultures, is recommended. Although the current guidelines refer to empirical antimicrobial treatment, various kinds of antimicrobial agents have been cited because of insufficient analyses on the spectrum of pathogens in AC. Enterococcus spp. is one of the most frequently isolated Gram-positive bacteria from the bile of patients with AC, but its risk factors have not been extensively studied. This study aimed to analyze the risk factors of AC caused by Enterococcus faecalis and Enterococcus faecium. Methods: Patients with AC who were hospitalized in a Japanese tertiary center between 2010 and 2015 were retrospectively analyzed. Patients’ first AC episodes in the hospital were evaluated. Results: A total of 266 patients with AC were identified. E. faecalis and/or E. faecium was isolated in 56 (21%) episodes of AC. Prior endoscopic sphincterotomy (EST), the presence of a biliary stent, prior cholecystectomy, and past intensive care unit admission were more frequently observed in AC patients with E. faecalis and/or E. faecium than in those without such bacteria. Prior EST was identified as an independent risk factor for AC caused by E. faecalis and/or E. faecium in the multivariate analysis. Conclusions: Given the intrinsic resistance of E. faecalis and E. faecium to antibiotics, clinicians should consider empirical therapy with anti-enterococcal antibiotics for patients with prior EST.
참고문헌 (33)
- Scott-Conner CE, "The pathophysiology of biliary obstruction and its effect on phagocytic and immune function", J Surg Res, 57, pp.316~336 (1994)
- Lipsett PA, "Acute cholangitis", Surg Clin North Am, 70, pp.1297~1312 (1990)
- Gigot JF, "Acute cholangitis : multivariate analysis of risk factors", Ann Surg, 209, pp.435~438 (1989)
- Lee JG, "Diagnosis and management of acute cholangitis", Nat Rev Gastroenterol Hepatol, 6, pp.533~541 (2009)
- Gomi H, "Tokyo Guidelines 2018 : antimicrobial therapy for acute cholangitis and cholecystitis", J Hepatobiliary Pancreat Sci, 25, pp.3~16 (2018)
- Zimmer V, "Acute bacterial cholangitis", Viszeralmedizin, 31, pp.166~172 (2015)
- Lee F, "Delayed endoscopic retrograde cholangiopancreatography is associated with persistent organ failure in hospitalised patients with acute cholangitis", Aliment Pharmacol Ther, 42, pp.212~220 (2015)
- Voigtländer T, "Microbiological analysis of bile and its impact in critically ill patients with secondary sclerosing cholangitis", J Infect, 70, pp.483~490 (2015)
- Gargouri D, "Microbiological study and antimicrobial susceptibility of bile in biliary therapeutic endoscopy", Tunis Med, 93, pp.602~605 (2015)
- Gomi H, "TG13 antimicrobial therapy for acute cholangitis and cholecystitis", J Hepatobiliary Pancreat Sci, 20, pp.60~70 (2013)
- Wisplinghoff H, "Nosocomial bloodstream infections in US hospitals : analysis of 24, 179 cases from a prospective nationwide surveillance study", Clin Infect Dis, 39, pp.309~317 (2004)
- Ramsey AM, "Secular trends of hospitalization with vancomycin-resistant enterococcus infection in the United States, 2000-2006", Infect Control Hosp Epidemiol, 30, pp.184~186 (2009)
- Watanabe S, "Genetic diversity of the low-level vancomycin resistance gene vanC-2", vanC-3and identification of a novel vanC subtype(vanC-4)in Enterococcus casseliflavus, 2009, pp.15, 1~9
- Lodise TP, "Clinical outcomes for patients with bacteremia caused by vancomycinresistant enterococcus in a level 1 trauma center", Clin Infect Dis, 34, pp.922~929 (2002)
- Reuken PA, "Risk factors for multidrug resistant pathogens and failure of empiric first-line therapy in acute cholangitis", PLoS One, 12, pp.e0169900~ (2017)
- Weber A, "Spectrum of pathogens in acute cholangitis in patients with and without biliary endoprosthesis", J Infect, 67, pp.111~121 (2013)
- Buschelman BJ, "Species identification and determination of high-level aminoglycoside resistance among enterococci : comparison study of sterile body fluid isolates, 1985-1991", Diagn Microbiol Infect Dis, 16, pp.119~122 (1993)
- Facklam RR, "Identification of Enterococcus species isolated from human infections by a conventional test scheme", J Clin Microbiol, 27, pp.731~734 (1989)
- Gordon S, "Antimicrobial susceptibility patterns of common and unusual species of enterococci causing infections in the United States. Enterococcal Study Group", J Clin Microbiol, 30, pp.2373~2378 (1992)
- Mondino SS, "Phenotypic and genotypic characterization of clinical and intestinal enterococci isolated from inpatients and outpatients in two Brazilian hospitals", Microb Drug Resist, 9, pp.167~174 (2003)
- Coombs GW, "Australian Enterococcal Sepsis Outcome Programme annual report, 2013", Commun Dis Intell Q Rep, 38, pp.E320~ (2014)
- Hidron AI, "NHSN annual update : antimicrobial-resistant pathogens associated with healthcare-associated infections : annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007", Infect Control Hosp Epidemiol, 29, pp.996~1011 (2008)
- Vega S, "Antimicrobial susceptibility among Gram-positive and Gram-negative organisms collected from the Latin American region between 2004 and 2015 as part of the Tigecycline Evaluation and Surveillance Trial", Ann Clin Microbiol Antimicrob, 16, pp.50~ (2017)
- Pinholt M, "Incidence, clinical characteristics and 30-day mortality of enterococcal bacteraemia in Denmark 2006-2009 : a population-based cohort study", Clin Microbiol Infect, 20, pp.145~151 (2014)
- Pappas G, "Enterococcus casseliflavus bacteremia : case report and literature review", J Infect, 48, pp.206~208 (2004)
- Tan CK, "Bacteremia caused by nonfaecalis and non-faecium Enterococcus species at a medical center in Taiwan, 2000 to 2008", J Infect, 61, pp.34~43 (2010)
- Choi SH, "Clinical features and outcomes of bacteremia caused by Enterococcus casseliflavus and Enterococcus gallinarum : analysis of 56 cases", Clin Infect Dis, 38, pp.53~61 (2004)
- Macleod SM, "Species interactions in mixedcommunity crystalline biofilms on urinary catheters", J Med Microbiol, 56(Pt 11), pp.1549~1557 (2007)
- Joo Won Chung, "Endoscopic Papillary Balloon Dilation for Removal of Choledocholithiasis: Indications, Advantages, Complications, and Long-Term Follow-Up Results", Gut and Liver, 5(1), pp.1~14 (2011), 거트앤리버 소화기연관학회협의회
- Takesue Y, "Antimicrobial susceptibility of common pathogens isolated from postoperative intra-abdominal infections in Japan", J Infect Chemother, 24, pp.330~340 (2018)
- Mendes RE, "Longitudinal(2001-14)analysis of enterococci and VRE causing invasive infections in European and US hospitals, including a contemporary(2010-13)analysis of oritavancin in vitro potency", J Antimicrob Chemother, 71, pp.3453~3458 (2016)
- Salvador VB, "Microbiology and antibiotic susceptibility of organisms in bile cultures from patients with and without cholangitis at an Asian academic medical center", Surg Infect(Larchmt), 12, pp.105~111 (2011)
- Kelly AM, "Clinical impact of blood cultures taken in the emergency department", J Accid Emerg Med, 15, pp.254~256 (1998)