scholarly journals Successful Control of an Endoscopic Retrograde Cholangiopancreatography–Associated Nosocomial Outbreak Caused by Klebsiella pneumoniae Carbapenemase Producing Klebsiella pneumoniae in a University Hospital in Bogota, Colombia

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Sandra Valderrama ◽  
Claudia Janneth Linares Miranda ◽  
Ángela Patricia Gonzalez Rubio ◽  
Sandra Gualtero ◽  
Gloria Cecilia Cortes Fraile ◽  
...  
2021 ◽  
Vol 09 (03) ◽  
pp. E292-E296
Author(s):  
Tone Lise Åvitsland ◽  
Lars Aabakken

Abstract Background and study aims Previous reports have suggested that endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients are safe. However, the total number of cases presented in the literature remains small. We present results regarding safety and outcomes in pediatric patients undergoing ERCP at Oslo University Hospital. Patients and methods Patients < 18 years who underwent ERCP between April 1999 and November 2017 were identified using procedure codes. Medical records were examined for age, gender, diagnosis, indications, type of sedation, findings, interventions, and complications. Results A total of 244 procedures were performed in 158 patients. Fifty-six of these were in 53 infants (age ≤ 1 year). Mean age was 8.8 years. The youngest patient was 8 days old. Mean weight was 5.0 kg in infants, the smallest weighing 2.9 kg. Cannulation failed in 19 (7.8 %). The main indication in infants was suspicion of biliary atresia (n = 38). Six of the procedures (10.7 %) were therapeutic. In children the main indications were biliary stricture (n = 64) and investigation of primary sclerosing cholangitis (PSC) (n = 45). 119 (63.2 %) of these procedures were therapeutic.Complications were uncommon in infants; only two episodes of infection were registered. In children (> 1 year) post-ERCP pancreatitis were seen in 10.4 %. Conclusions Our retrospective series of ERCP procedures includes 56 procedures in infants, which is one of the largest series presented. Complications in infants are rare and post-ERCP pancreatitis was not seen. In older children 10.4 % experienced post-ERCP pancreatitis. In expert hands, ERCP was shown to be acceptably feasible and safe in infants and children.


2019 ◽  
Author(s):  
Yuhua Yuan ◽  
Qiucheng Shi ◽  
Li Fang ◽  
Jin Zhao ◽  
Yaqin Ni ◽  
...  

Abstract Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is associated with nosocomial infections that poses a serious threat to public health. According to a previous study, endoscopic retrograde cholangiopancreatography (ERCP) is considered a risk factor of CRKP transmission in the hospital. Methods: In this study, two cases infected with CRKP after ERCP were investigated. The origin of CRKP was determined by collecting the isolates from patients and screening the environment for ERCP units and the specific endoscopes. The antimicrobials susceptibility testing and molecular typing were performed for these CRKP. After post-ERCP infection happened, the procedure of endoscope disinfection was changed and hydrogen dioxide disinfection of ERCP unit was performed.Results: A total of five CRKP isolates were obtained from patients and screening the environment for ERCP units and the specific endoscopes, including three from the patients and two from the ERCP operating room. The CRKP from the patients and environment were both ST11, and the pulsed-field gel electrophoresis results showed that they shared identical bands, which indicated that the contaminated environment was associated with the nosocomial CRKP infections. After the control measures of endoscopes and hydrogen dioxide disinfection, post-ERCP infection decreased in the next six months.Conclusion: Early warning and response system should be established to control the spreading of CRKP in ERCP operation unit.


2012 ◽  
Vol 56 (4) ◽  
pp. 2158-2161 ◽  
Author(s):  
Martin Hoenigl ◽  
Thomas Valentin ◽  
Gernot Zarfel ◽  
Benjamin Wuerstl ◽  
Eva Leitner ◽  
...  

ABSTRACTTo date, no outbreak of carbapenemase-producing bacteria has been reported for Austria. While outbreaks ofKlebsiella pneumoniaecarbapenemase (KPC)-producingK. pneumoniaehave been increasingly reported, no outbreak caused by KPC-producingKlebsiella oxytocahas been described yet, to the best of our knowledge. We report an outbreak of KPC-producingK. oxytoca. In 5 months, 31 KPC-producingKlebsiella oxytocastrains were isolated from five patients. All patients were admitted to the same medical intensive care unit in Austria.


2017 ◽  
Vol 5 (1) ◽  
pp. 105
Author(s):  
Wael Doush ◽  
Mohammed A/Galil ◽  
Shakir Ibrahim

Background: The meticulous identification of the hepatobiliary tree system normal anatomy during surgical operations is crucial in iatrogenic injury prevention. Equally important, an understanding of the congenital variations of biliary and vascular anatomy, as the literature abounds with reports of specific anatomical variations, and their surgical implications.Aim: This study aimed to study the presence of anatomical variations within the hepatobiliary system in Sudanese population undergoing endoscopic retrograde cholangiopancreatography (ERCP).Patients and methods: The records of patients undergoing ERCP in Soba University Hospital during 2004 to 2008 were analyzed. There were 277 Sudanese patients who had complained of right hypochondrial abdominal pain & history of jaundice (obstructive jaundice) that underwent ERCP were included within this study. The exclusion criteria included the following: Sudanese patients in whom ERCP failed or patients who had advanced hepatobiliary disease like cancers, strictures either cancerous or iatrogenic, fistula and iatrogenic biliary leak.Results: The analysis of 277 Sudanese patients undergoing ERCP of the hepatobiliary system showed the following results regarding the variations: The choledochal cyst type one (fusiform type) was present in 3 (1.08%) patients; very low cystic duct insertion (parallel) was present in 1 (0.36%) patient and long cystic duct was present in 3 (1.08%) patients. The ampulla of Vater size variations occurred as A) Normal in 158 (57%) patient, B) Small in 56 (20.2%) patients, C) Large in 29 (10.5%) patients, D) Periampullary diverticula in 4 (1.4%) patients and E) unclassified in 30 (10.8%) patients. Other forms of congenital anomalies were not found.Conclusion: The using of endoscopic retrograde cholangiopancreatography (ERCP) is a reliable radiological method for depicting congenital anomalies of the hepatobiliary system, but it is an invasive procedure.


Author(s):  
Felipe Francisco Tuon ◽  
Kassia Cordova ◽  
Thayrine Mayara Dario ◽  
Luciana de Souza Nunes ◽  
Afonso Luís Barth ◽  
...  

Endoscopy ◽  
2010 ◽  
Vol 42 (11) ◽  
pp. 895-899 ◽  
Author(s):  
C. Aumeran ◽  
L. Poincloux ◽  
B. Souweine ◽  
F. Robin ◽  
H. Laurichesse ◽  
...  

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