Poor outcomes after hepatectomy in patients with ascites infected by methicillin‐resistant staphylococci. (22nd October 2014)

• Record Type: Journal Article
• Authors: Nitta, Hidetoshi; Beppu, Toru; Itoyama, Akari; Higashi, Takaaki; Sakamoto, Keita; Nakagawa, Shigeki; Mima, Kosuke; Okabe, Hirohisa; Imai, Katsunori; Hayashi, Hiromitsu; Hashimoto, Daisuke; Chikamoto, Akira; Ishiko, Takatoshi; Baba, Hideo
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 22:Number 2(2015)
• Page Start: 166
• Page End: 176
• Publication Date: 2014-10-22
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.175
• Languages: English
• ISSNs: 1868-6974

Abstract

<abstract abstract-type="main" id="jhbp175-abs-0001"> <title>Abstract</title> <sec id="jhbp175-sec-0001" sec-type="section"> <title>Background</title> <p id="jhbp175-para-0001">This study was designed to investigate the association between infectious ascites, clinical parameters and treatment outcomes after hepatectomy.</p> </sec> <sec id="jhbp175-sec-0002" sec-type="section"> <title>Methods</title> <p id="jhbp175-para-0002">Of 891 patients who underwent hepatectomy between 2006 and 2013, 74 who underwent paracentesis for bacterial cultivation of postoperative ascites after hepatectomy were analyzed.</p> </sec> <sec id="jhbp175-sec-0003" sec-type="section"> <title>Results</title> <p id="jhbp175-para-0003">Of the 74 patients, 42 had positive bacterial cultures (positive group) and 32 patients had negative cultures (negative group). Hospital mortality was significantly higher in the positive group than in the negative group [9/42 (21.4%) vs. 2/32 (6.3%); <italic>P</italic> = 0.035]. Hospital mortality associated with each bacterial strain was as follows: methicillin‐resistant staphylococci (MRS) (5/13, 38.5%), staphylococci (2/11, 18.2%), enterococci (2/12, 16.7%), <italic>Enterobacter</italic> (0/3, 0%), <italic>Klebsiella</italic> (0/2, 0%), and others (0/1, 0%). Cox proportional multivariate analysis revealed that MRS infection in ascites was the only risk factor of hospital death (HR = 5.08, <italic>P</italic> = 0.041) and MRS wound infection was the only risk factor to predict MRS infection in ascites (HR = 5.67, <italic>P</italic> = 0.015).</p> </sec> <sec id="jhbp175-sec-0004" sec-type="section"> <title>Conclusion</title> <p id="jhbp175-para-0004">Postoperative MRS infection in postoperative ascites after hepatectomy is a potentially fatal complication; therefore, the prevention of MRS wound infection is critical to decrease postoperative hospital mortality.</p> </sec> </abstract>