Volume 21 Issue 6
Jun.  2023
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Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(6): 950-953
ZHANG Huanhuan, LUO Mingyang, WANG Xin, YAN Dong, ZENG Yanli. Analysis of etiology and inflammatory markers in patients with biliary tract infection after choledocchojejunostomy[J]. Chinese Journal of General Practice, 2023, 21(6): 950-953. doi: 10.16766/j.cnki.issn.1674-4152.003022
Citation: ZHANG Huanhuan, LUO Mingyang, WANG Xin, YAN Dong, ZENG Yanli. Analysis of etiology and inflammatory markers in patients with biliary tract infection after choledocchojejunostomy[J]. Chinese Journal of General Practice, 2023, 21(6): 950-953. doi: 10.16766/j.cnki.issn.1674-4152.003022
shu

Analysis of etiology and inflammatory markers in patients with biliary tract infection after choledocchojejunostomy

doi: 10.16766/j.cnki.issn.1674-4152.003022
  • 1.

    Department of Infectious Diseases, Henan University Peopl's Hospital, Zhengzhou, Henan 450003, China

Funds:

 YXKC2020042

  • Received Date: 2023-01-19
    Available Online: 2023-08-26
    Abstract
  •   Objective  To investigate the pathogenic characteristics and drug resistance of pathogenic bacteria in biliary tract infection after cholangioenterostomy in Henan University People's Hospital and to evaluate the diagnostic value of biliary tract infection by relevant inflammatory markers.  Methods  A total of 351 patients who underwent choledocchojejunostomy from September 2020 to August 2022 in Henan Provincial People's Hospital were enrolled as the research objects. The characteristics of biliary tract infection pathogens and the results of drug sensitivity tests were analyzed. The levels of leukocytes, neutrophils, C-reactive protein (CRP), creactive protein-to-albumin ratio (CAR) and systemic immune-inflammation index (SII) were evaluated in diagnosing the occurrence of biliary tract infection.  Results  Among 351 patients, 31 had biliary tract infections (infection group, the rest were uninfected group), and the infection rate was 8.83%. A total of 36 strains of pathogenic bacteria were isolated, including 25 strains of Gram-negative bacteria (69.4%) and 8 strains of Gram-positive bacteria (22.22%) and 3 strains of fungi (8.33%). The common pathogens were Escherichia coli, Klebsiella pneumoniae and Enterococcus faecium. Among the Gram-negative bacteria, Escherichia coli and Klebsiella pneumoniae had the highest drug-resistance rates to ampicillin and the lowest drug-resistance rates to carbapenem antibiotics. There was no statistically significant difference in WBC, NEU, CAR, CRP, and SII levels between the two groups of patients before surgery. The level of NEU, CAR, WBC and CRP between the two groups on the second and third day after operation were higher than those before operation (all P < 0.05), and the infection group were higher than the uninfected group (all P < 0.05). The results of ROC curve showed that the area under the curve of combined indexes was 0.887, and its predictive value were higher than those of each individual index (all P < 0.05).  Conclusion  The main pathogenic bacteria of postoperative biliary tract infection in patients are Gram-negative bacteria such as Escherichia coli and Klebsiella pneumoniae, and they have strong drug-resistance to commonly used antibacterial drugs which can be used to guide postoperative preventive medication for biliary tract infection. The detection of serum WBC, NEU, CAR and CRP levels in patients can predict the occurrence of biliary tract infection after surgery.

     

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