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The Epidemiology and Etiology of Cholangitis After Kasai Portoenterostomy in Patients With Biliary Atresia

Authors
 Baek, Seung Hwan  ;  Kang, Ji-Man  ;  Ihn, Kyong  ;  Han, Seok Joo  ;  Koh, Hong  ;  Ahn, Jong Gyun 
Citation
 JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION, Vol.70(2) : 171-177, 2020 
Journal Title
 JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION 
ISSN
 0277-2116 
Issue Date
2020
Abstract
OBJECTIVES: We investigated the incidence and characteristics of cholangitis after Kasai portoenterostomy (KPE) in patients with biliary atresia. We also examined the distribution and antimicrobial susceptibility patterns of the causative pathogens, which were isolated in sterile specimens, such as blood and ascites. METHODS: A retrospective chart review was performed in patients with biliary atresia who underwent KPE at Severance Children's Hospital in Korea from 2006 to 2015. The Kaplan-Meier method was used to assess the cumulative incidence of cholangitis. RESULTS: Among the 160 included patients, there were 494 episodes of cholangitis in 126 patients (78.8%) during the study period. The cumulative incidence of cholangitis at 1 and 5 years after KPE was 75.5% and 84.2%, respectively, and cholangitis recurred in most cases (76.2%). The cumulative incidence of culture-proven cholangitis at 1 and 5 years after KPE was 22.1% and 23.9%, respectively. Enterococcus faecium (27.7%) was the most prevalent pathogen, followed by Escherichia coli (14.9%), Enterobacter cloacae (10.6%), and Klebsiella pneumoniae (8.5%). Gram-positive isolates (n = 19) showed low susceptibility to ampicillin (42.1%) and gentamicin (66.7%), and only 38.1% of Gram-negative isolates (n = 21) were susceptible to cefotaxime. CONCLUSIONS: The present study is the largest to show the high incidence and characteristics of cholangitis after KPE in patients with biliary atresia. Enterococcus is a common pathogen of cholangitis after KPE and should be considered when choosing empiric antimicrobial therapy.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00005176-202002000-00007&LSLINK=80&D=ovft
DOI
10.1097/MPG.0000000000002555
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Ji-Man(강지만)
Koh, Hong(고홍) ORCID logo https://orcid.org/0000-0002-3660-7483
Baek, Seung Hwan(백승환)
Ahn, Jong Gyun(안종균) ORCID logo https://orcid.org/0000-0001-5748-0015
Ihn, Kyong(인경) ORCID logo https://orcid.org/0000-0002-6161-0078
Han, Seok Joo(한석주) ORCID logo https://orcid.org/0000-0001-5224-1437
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/175564
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