Biliary endoprosthesis: a prospective analysis of bacterial colonization and risk factors for sludge formation.

Bacterial colonization of biliary stents is one of the driving forces behind sludge formation which may result in stent occlusion. Major focus of the study was to analyze the spectrum and number of microorganisms in relation to the indwelling time of stents and the risk factors for sludge formation....

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Jochen Schneider, Alexander Hapfelmeier, Julia Fremd, Philipp Schenk, Andreas Obermeier, Rainer Burgkart, Stefanie Forkl, Susanne Feihl, Nina Wantia, Bruno Neu, Monther Bajbouj, Stefan von Delius, Roland M Schmid, Hana Algül, Andreas Weber
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/72986c0f421d4447bf6e96f6dcf89445
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:72986c0f421d4447bf6e96f6dcf89445
record_format	dspace
spelling	oai:doaj.org-article:72986c0f421d4447bf6e96f6dcf894452021-11-25T05:56:37ZBiliary endoprosthesis: a prospective analysis of bacterial colonization and risk factors for sludge formation.1932-620310.1371/journal.pone.0110112https://doaj.org/article/72986c0f421d4447bf6e96f6dcf894452014-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0110112https://doaj.org/toc/1932-6203Bacterial colonization of biliary stents is one of the driving forces behind sludge formation which may result in stent occlusion. Major focus of the study was to analyze the spectrum and number of microorganisms in relation to the indwelling time of stents and the risk factors for sludge formation. 343 stents were sonicated to optimize the bacterial release from the biofilm and identified by matrix-associated laser desorption/ionization-time of flight mass spectrometer (MALDI-TOF). 2283 bacteria were analyzed in total. The most prevalent microorganisms were Enterococcus species (spp.) (504;22%), followed by Klebsiella spp. (218;10%) and Candida spp. (188;8%). Colonization of the stents mainly began with aerobic gram-positive bacteria (43/49;88%) and Candida spp. (25/49;51%), whereas stents with an indwelling time>60 days(d) showed an almost equal colonization rate by aerobic gram-negative (176/184;96%) and aerobic gram-positive bacteria (183/184;99%) and a high proportion of anaerobes (127/184;69%). Compared to stents without sludge, more Clostridium spp. [(P = 0.02; Odds Ratio (OR): 2.4; 95% confidence interval (95%CI): (1.1-4.9)]) and Staphylococcus spp. [(P = 0.03; OR (95%CI): 4.3 (1.1-16.5)] were cultured from stents with sludge. Multivariate analysis revealed a significant relationship between the number of microorganisms [P<0.01; OR (95%CI): 1.3(1.1-1.5)], the indwelling time [P<0.01; 1-15 d vs. 20-59 d: OR (95%CI): 5.6(1.4-22), 1-15 d vs. 60-3087 d: OR (95% CI): 9.5(2.5-35.7)], the presence of sideholes [P<0.01; OR (95%CI): 3.5(1.6-7.9)] and the occurrence of sludge. Stent occlusion was found in 70/343(20%) stents. In 35% of cases, stent occlusion resulted in a cholangitis or cholestasis. In conclusion, microbial colonization of the stents changed with the indwelling time. Sludge was associated with an altered spectrum and an increasing number of microorganisms, a long indwelling time and the presence of sideholes. Interestingly, stent occlusion did not necessarily lead to a symptomatic biliary obstruction.Jochen SchneiderAlexander HapfelmeierJulia FremdPhilipp SchenkAndreas ObermeierRainer BurgkartStefanie ForklSusanne FeihlNina WantiaBruno NeuMonther BajboujStefan von DeliusRoland M SchmidHana AlgülAndreas WeberPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 10, p e110112 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jochen Schneider Alexander Hapfelmeier Julia Fremd Philipp Schenk Andreas Obermeier Rainer Burgkart Stefanie Forkl Susanne Feihl Nina Wantia Bruno Neu Monther Bajbouj Stefan von Delius Roland M Schmid Hana Algül Andreas Weber Biliary endoprosthesis: a prospective analysis of bacterial colonization and risk factors for sludge formation.
description	Bacterial colonization of biliary stents is one of the driving forces behind sludge formation which may result in stent occlusion. Major focus of the study was to analyze the spectrum and number of microorganisms in relation to the indwelling time of stents and the risk factors for sludge formation. 343 stents were sonicated to optimize the bacterial release from the biofilm and identified by matrix-associated laser desorption/ionization-time of flight mass spectrometer (MALDI-TOF). 2283 bacteria were analyzed in total. The most prevalent microorganisms were Enterococcus species (spp.) (504;22%), followed by Klebsiella spp. (218;10%) and Candida spp. (188;8%). Colonization of the stents mainly began with aerobic gram-positive bacteria (43/49;88%) and Candida spp. (25/49;51%), whereas stents with an indwelling time>60 days(d) showed an almost equal colonization rate by aerobic gram-negative (176/184;96%) and aerobic gram-positive bacteria (183/184;99%) and a high proportion of anaerobes (127/184;69%). Compared to stents without sludge, more Clostridium spp. [(P = 0.02; Odds Ratio (OR): 2.4; 95% confidence interval (95%CI): (1.1-4.9)]) and Staphylococcus spp. [(P = 0.03; OR (95%CI): 4.3 (1.1-16.5)] were cultured from stents with sludge. Multivariate analysis revealed a significant relationship between the number of microorganisms [P<0.01; OR (95%CI): 1.3(1.1-1.5)], the indwelling time [P<0.01; 1-15 d vs. 20-59 d: OR (95%CI): 5.6(1.4-22), 1-15 d vs. 60-3087 d: OR (95% CI): 9.5(2.5-35.7)], the presence of sideholes [P<0.01; OR (95%CI): 3.5(1.6-7.9)] and the occurrence of sludge. Stent occlusion was found in 70/343(20%) stents. In 35% of cases, stent occlusion resulted in a cholangitis or cholestasis. In conclusion, microbial colonization of the stents changed with the indwelling time. Sludge was associated with an altered spectrum and an increasing number of microorganisms, a long indwelling time and the presence of sideholes. Interestingly, stent occlusion did not necessarily lead to a symptomatic biliary obstruction.
format	article
author	Jochen Schneider Alexander Hapfelmeier Julia Fremd Philipp Schenk Andreas Obermeier Rainer Burgkart Stefanie Forkl Susanne Feihl Nina Wantia Bruno Neu Monther Bajbouj Stefan von Delius Roland M Schmid Hana Algül Andreas Weber
author_facet	Jochen Schneider Alexander Hapfelmeier Julia Fremd Philipp Schenk Andreas Obermeier Rainer Burgkart Stefanie Forkl Susanne Feihl Nina Wantia Bruno Neu Monther Bajbouj Stefan von Delius Roland M Schmid Hana Algül Andreas Weber
author_sort	Jochen Schneider
title	Biliary endoprosthesis: a prospective analysis of bacterial colonization and risk factors for sludge formation.
title_short	Biliary endoprosthesis: a prospective analysis of bacterial colonization and risk factors for sludge formation.
title_full	Biliary endoprosthesis: a prospective analysis of bacterial colonization and risk factors for sludge formation.
title_fullStr	Biliary endoprosthesis: a prospective analysis of bacterial colonization and risk factors for sludge formation.
title_full_unstemmed	Biliary endoprosthesis: a prospective analysis of bacterial colonization and risk factors for sludge formation.
title_sort	biliary endoprosthesis: a prospective analysis of bacterial colonization and risk factors for sludge formation.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/72986c0f421d4447bf6e96f6dcf89445
work_keys_str_mv	AT jochenschneider biliaryendoprosthesisaprospectiveanalysisofbacterialcolonizationandriskfactorsforsludgeformation AT alexanderhapfelmeier biliaryendoprosthesisaprospectiveanalysisofbacterialcolonizationandriskfactorsforsludgeformation AT juliafremd biliaryendoprosthesisaprospectiveanalysisofbacterialcolonizationandriskfactorsforsludgeformation AT philippschenk biliaryendoprosthesisaprospectiveanalysisofbacterialcolonizationandriskfactorsforsludgeformation AT andreasobermeier biliaryendoprosthesisaprospectiveanalysisofbacterialcolonizationandriskfactorsforsludgeformation AT rainerburgkart biliaryendoprosthesisaprospectiveanalysisofbacterialcolonizationandriskfactorsforsludgeformation AT stefanieforkl biliaryendoprosthesisaprospectiveanalysisofbacterialcolonizationandriskfactorsforsludgeformation AT susannefeihl biliaryendoprosthesisaprospectiveanalysisofbacterialcolonizationandriskfactorsforsludgeformation AT ninawantia biliaryendoprosthesisaprospectiveanalysisofbacterialcolonizationandriskfactorsforsludgeformation AT brunoneu biliaryendoprosthesisaprospectiveanalysisofbacterialcolonizationandriskfactorsforsludgeformation AT montherbajbouj biliaryendoprosthesisaprospectiveanalysisofbacterialcolonizationandriskfactorsforsludgeformation AT stefanvondelius biliaryendoprosthesisaprospectiveanalysisofbacterialcolonizationandriskfactorsforsludgeformation AT rolandmschmid biliaryendoprosthesisaprospectiveanalysisofbacterialcolonizationandriskfactorsforsludgeformation AT hanaalgul biliaryendoprosthesisaprospectiveanalysisofbacterialcolonizationandriskfactorsforsludgeformation AT andreasweber biliaryendoprosthesisaprospectiveanalysisofbacterialcolonizationandriskfactorsforsludgeformation
_version_	1718414347197218816

Biliary endoprosthesis: a prospective analysis of bacterial colonization and risk factors for sludge formation.

Ejemplares similares