@article{3122798,
    title = "Microbe isolation from blood, central venous catheters, and fluid collections after liver resections",
    author = "Kostakis, I.D. and Machairas, N. and Prodromidou, A. and Garoufalia, Z. and Charalampoudis, P. and Sotiropoulos, G.C.",
    journal = "Surgical Infections",
    year = "2019",
    volume = "20",
    number = "1",
    pages = "49-54",
    publisher = "MARY ANN LIEBERT INC PUBL",
    issn = "1096-2964, 1557-8674",
    doi = "10.1089/sur.2018.122",
    keywords = "adult;  aged;  Article;  bacteremia;  bacterium identification;  bacterium isolation;  bile duct bypass;  bile duct carcinoma;  blood culture;  catheter infection;  coagulase negative Staphylococcus;  controlled study;  female;  human;  intensive care unit;  intestine flora;  laparoscopic surgery;  length of stay;  liver cell carcinoma;  liver metastasis;  liver resection;  major clinical study;  male;  nonhuman;  postoperative period;  priority journal;  retrospective study;  risk factor;  bacteremia;  bacterium;  blood;  central venous catheter;  classification;  complication;  exudate;  isolation and purification;  liver disease;  microbiology;  middle aged;  postoperative complication;  prospective study;  risk factor;  very elderly;  young adult, Adult;  Aged;  Aged, 80 and over;  Bacteremia;  Bacteria;  Blood;  Central Venous Catheters;  Exudates and Transudates;  Female;  Humans;  Liver Diseases;  Male;  Middle Aged;  Postoperative Complications;  Prospective Studies;  Risk Factors;  Young Adult",
    abstract = "Background: Our goal was to evaluate the microbe species responsible for bacteremia or infections related to central venous catheter (CVC) or fluid collections after liver resection. Patients and Methods: Data from 112 patients (68 males, 44 females) who underwent liver resection over a period of 63 months were reviewed. Patient and tumor characteristics, intra-operative and post-operative data, and the results from cultures of peripheral blood, CVC tips and drained intra-abdominal or intra-throracic fluid collections were collected. Results: There were positive blood cultures in 20 patients (17.9%). Coagulase-negative staphylococci (CoNS) and bacteria of enteric flora were the micro-organisms found most frequently and half of the cases had multiple isolated microbe species. The construction of a bilioenteric anastomosis was an independent risk factor for microbe isolation in peripheral blood (odds ratio [OR]: 11, p = 0.01). Furthermore, there were positive cultures of the CVC tip in 14 patients (12.5%), with CoNS being the micro-organism found most frequently and most cases had only one isolated microbe species. No specific risk factor for catheter-related infections was detected. In addition, there were positive cultures of drained fluid collections in 19 patients (17%), with bacteria of enteric flora being the micro-organisms found most frequently and the majority of cases had multiple isolated microbe species. The construction of a bilioenteric anastomosis (OR: 23.5, p = 0.002) and the laparoscopic approach (OR: 4.7, p = 0.0496) were independent risk factors for microbe isolation in drained fluid collections. Finally, the presence of positive blood cultures was associated with the presence of positive culture of CVC tips (p = 0.018) and drained fluid collections (p = 0.001). Conclusions: Post-operative bacteremia, colonization of CVCs, and contamination of fluid collections occur frequently after liver resections and various microbe species may be involved. Patients who undergo hepatectomy and a synchronous construction of a bilioenteric anastomosis are at increased risk of bacteremia development and contamination of fluid collections. © 2018, Mary Ann Liebert, Inc., publishers."
}