An analysis of the incidence, causes and preventative approaches to gram-negative bloodstream infections of hepatopancreatobiliary origin
© The Author(s) 2020..
BACKGROUND: Gram-negative bloodstream infection (GNBSI) is a threat to public health in terms of mortality and antibiotic resistance. The hepatopancreatobiliary (HPB) cohort accounts for 15%-20% of GNBSI, yet few strategies have been explored to reduce HPB GNBSI.
AIM: To identify clinical factors contributing to HPB GNBSI and strategies for its prevention.
METHODS: We performed a retrospective analysis of 433 cases of HPB GNBSI presenting to four hospitals between April 2015 and May 2019. We extracted key data from hospital and primary care records including: the underlying source of GNBSI; previous documentation of biliary disease; and any previous surgical or non-surgical management.
FINDINGS: Out of 433 cases of HPB GNBSI, 388 had clear evidence of HPB origin. The source of GNBSI was related to gallstone disease in 282 of the 388 cases (73%) and to HPB malignancy in 70 cases (18%). Of the gallstone-related cases, 117 had previously been diagnosed with symptomatic gallstones. Of the 117 with a previous presentation, 93 could have been prevented with a laparoscopic cholecystectomy at the first presentation of gallstones, while 18 could have been prevented if intraoperative biliary tract imaging had been performed during a prior cholecystectomy. Of the 70 malignant cases, five could have been prevented through earlier biliary stenting, use of metal stents instead of plastic stents or earlier pancreaticoduodenectomy.
DISCUSSION: The incidence of HPB GNBSI could be reduced by up to 30% by the implementation of alternative management strategies in this cohort.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
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| Enthalten in: |
Journal of infection prevention - 22(2021), 3 vom: 30. Mai, Seite 111-118 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Majeed, Mustafa [VerfasserIn] |
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| Links: |
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| Themen: |
Bloodstream infection |
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| Anmerkungen: |
Date Revised 03.05.2022 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1177/1757177420973763 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM327855436 |
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| 100 | 1 | |a Majeed, Mustafa |e verfasserin |4 aut | |
| 245 | 1 | 3 | |a An analysis of the incidence, causes and preventative approaches to gram-negative bloodstream infections of hepatopancreatobiliary origin |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Revised 03.05.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © The Author(s) 2020. | ||
| 520 | |a BACKGROUND: Gram-negative bloodstream infection (GNBSI) is a threat to public health in terms of mortality and antibiotic resistance. The hepatopancreatobiliary (HPB) cohort accounts for 15%-20% of GNBSI, yet few strategies have been explored to reduce HPB GNBSI | ||
| 520 | |a AIM: To identify clinical factors contributing to HPB GNBSI and strategies for its prevention | ||
| 520 | |a METHODS: We performed a retrospective analysis of 433 cases of HPB GNBSI presenting to four hospitals between April 2015 and May 2019. We extracted key data from hospital and primary care records including: the underlying source of GNBSI; previous documentation of biliary disease; and any previous surgical or non-surgical management | ||
| 520 | |a FINDINGS: Out of 433 cases of HPB GNBSI, 388 had clear evidence of HPB origin. The source of GNBSI was related to gallstone disease in 282 of the 388 cases (73%) and to HPB malignancy in 70 cases (18%). Of the gallstone-related cases, 117 had previously been diagnosed with symptomatic gallstones. Of the 117 with a previous presentation, 93 could have been prevented with a laparoscopic cholecystectomy at the first presentation of gallstones, while 18 could have been prevented if intraoperative biliary tract imaging had been performed during a prior cholecystectomy. Of the 70 malignant cases, five could have been prevented through earlier biliary stenting, use of metal stents instead of plastic stents or earlier pancreaticoduodenectomy | ||
| 520 | |a DISCUSSION: The incidence of HPB GNBSI could be reduced by up to 30% by the implementation of alternative management strategies in this cohort | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Gram-negative | |
| 650 | 4 | |a bloodstream infection | |
| 650 | 4 | |a gallstones | |
| 650 | 4 | |a hepatopancreatobiliary | |
| 650 | 4 | |a infection prevention | |
| 650 | 4 | |a malignancy | |
| 700 | 1 | |a Ward, Harry |e verfasserin |4 aut | |
| 700 | 1 | |a Wade, Cian |e verfasserin |4 aut | |
| 700 | 1 | |a Butcher, Lisa |e verfasserin |4 aut | |
| 700 | 1 | |a Soonawalla, Zahir |e verfasserin |4 aut | |
| 700 | 1 | |a Bond-Smith, Giles |e verfasserin |4 aut | |
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