Microbial contamination, infection, and antimicrobial use during total pancreatectomy with islet autotransplantation

Michael J. Trisler, Rachel M. Kruer, Andrew S. Jarrell, Mahya Faghih, Christi M. Walsh, Vikesh K. Singh, Erica Hall, Rita R. Kalyani, Martin A. Makary, Laura A. Hatfield

Research output: Contribution to journalArticle

Abstract

Objectives Total pancreatectomy with islet autotransplantation can relieve pain associated with chronic pancreatitis while preserving islet function. Islet preparations are often contaminated by enteric flora. We assessed the impact of contaminated islet preparations on the prevalence of postoperative infection. Methods Electronic health records for patients who underwent total pancreatectomy with islet autotransplantation from August 1, 2011, to November 15, 2017 were retrospectively reviewed to compare the prevalence of postoperative infection in patients with a positive islet culture and islet culture negative patients. Results Sixty-one patients were included. Twenty-nine patients (47.5%) had a positive islet culture, and 23 (79.3%) of these patients received antimicrobial prophylaxis. The prevalence of postoperative infection did not differ between the islet culture positive and islet culture negative groups (41% vs 34%, P = 0.57). No infections occurred in the 6 islet culture positive patients who did not receive prophylaxis. No difference in intensive care unit or hospital length of stay or in 30-day or 90-day readmission rates were observed. Conclusions Despite the common use of postoperative systemic antimicrobials, we observed no difference in the prevalence of postoperative infection, length of stay, or hospital readmission in patients receiving a contaminated islet preparation. If prophylactic antimicrobials are used, the duration should be minimized.

Original languageEnglish (US)
Pages (from-to)1050-1055
Number of pages6
JournalPancreas
Volume48
Issue number8
DOIs
StatePublished - Sep 1 2019

Keywords

  • antimicrobial
  • contamination
  • infection
  • islet autotransplantation
  • pancreatectomy
  • prophylaxis

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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