Radiology, Vol 191, 495-499, Copyright © 1994 by Radiological Society of North America
Bloodstream infections after interventional procedures in the biliary tract
CD Clark, D Picus and WC Dunagan
Department of Pharmacy, Indiana University Medical Center, Indianapolis, MO 63110.
PURPOSE: To assess the adequacy of prophylaxis for interventional
radiologic biliary procedures and the etiologic organisms of subsequent
bloodstream infections. MATERIALS AND METHODS: Data from 148 patients who
underwent 480 interventional radiologic biliary procedures were evaluated
for evidence of bloodstream infection. Data analyzed included type of
procedure performed, whether an antibiotic was used, and evidence of
infectious complications occurring during and within 72 hours after the
procedure. All culture data obtained before and after the procedure were
recorded. RESULTS: Seven cases of new bloodstream infection were
identified, five of which were caused by Enterococcus species. No
substantial risk factors for bloodstream infection were identified,
although it occurred only in patients who had recently undergone biliary
surgery or underwent manipulations other than simple cholangiography.
Microbial colonization of the bile was associated with older age. Evidence
of possible or proved infection after the first interventional procedure
was more common in patients with positive bile cultures. CONCLUSION:
Although the importance of enterococcal bacteremia is uncertain, current
recommendations for cephalosporin prophylaxis for interventional radiologic
biliary procedures should be reevaluated.
