Early Infectious Complications After Total Pancreatectomy with Islet Autotransplantation: a Single Center Experience View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-02-04

AUTHORS

Justyna E. Gołębiewska, Piotr J. Bachul, Natalie Fillman, Mark R. Kijek, Lindsay Basto, Monica Para, Laurencia Perea, Karolina Gołąb, Ling-jia Wang, Martin Tibudan, Alicja Dębska-Ślizień, Jeffrey B. Matthews, John Fung, Piotr Witkowski

ABSTRACT

INTRODUCTION: We assessed whether positive microbiological cultures from the islet preparation had any effect on the risk of infectious complications (IC) after total pancreatectomy with islet autotransplantation (TPIAT) in our center. METHODS: We analyzed preservation fluid and final islet product surveillance cultures with reference to clinical data of patients undergoing TPIAT. All patients received routine prophylactic broad-spectrum antibiotics. RESULTS: The study involved 10 men and 18 women with a median age of 39 years. Over 30% of surveillance cultures during pancreas processing grew bacterial strains with predominantly polymicrobial contaminations (13 of 22 (59%)). At least one positive culture was identified in almost half of the patients (46%) undergoing TPIAT and a third had both surveillance cultures positive. Infectious complications affected 50% of patients. After excluding cases of PICC line-associated bacteremia/fungemia present on admission, incidence of IC was higher in cases of positive final islet product culture than in those with negative result (57% vs. 21%), which also corresponded with the duration of chronic pancreatitis (p = 0.04). Surgical site infections were the most common IC, followed by fever of unknown origin. There was no concordance between pathogens isolated from the pancreas and those identified during the infection. CONCLUSIONS: While IC was common among TPIAT patients, we found no concordance between pathogens isolated from the pancreas and those identified during infection. Contamination of the final islet product was of clinical importance and could represent a surrogate marker for higher susceptibility to infection. More... »

PAGES

1-10

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11605-019-04118-y

DOI

http://dx.doi.org/10.1007/s11605-019-04118-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1111909984

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30719679


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