Τίτλος:
Microbe isolation from blood, central venous catheters, and fluid collections after liver resections
Περίληψη:
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.
Συγγραφείς:
Kostakis, I.D.
Machairas, N.
Prodromidou, A.
Garoufalia, Z.
Charalampoudis, P.
Sotiropoulos, G.C.
Λέξεις-κλειδιά:
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
