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Pneumococcal biliary tract infections - How rare are they?
Hiroshi Morioka1, Mitsutaka Iguchi2, Mitsuru Oodate3
1Department of Infectious Diseases, Nagoya University Hospital, Japan; Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Japan.
Summary
Pneumococcal biliary tract infections (PBTIs) are not as rare as previously thought. This study found PBTIs to be a common cause of pneumococcal bacteremia in patients with biliary issues.
Area of Science:
- Infectious Diseases
- Hepatology
- Microbiology
Background:
- Pneumococcal biliary tract infections (PBTIs) are considered rare due to Streptococcus pneumoniae's bile solubility.
- Previous literature suggests limited occurrence of PBTIs.
Purpose of the Study:
- To determine the actual occurrence and clinical characteristics of PBTIs.
- To investigate the incidence of PBTIs in a tertiary care setting.
Main Methods:
- Retrospective case series review from January 2006 to August 2014.
- Inclusion criteria: blood or bile culture positive for Streptococcus pneumoniae and diagnosed cholangitis or cholecystitis (Tokyo Guideline 2013).
- Data collected: clinical information, treatments, and outcomes.
Main Results:
- Ten patients diagnosed with PBTI over 104 months.
- Most patients (9/10) had pre-existing biliary tract problems and indwelling biliary devices.
- PBTIs were identified as a relatively common cause of pneumococcal bacteremia in this center.
Conclusions:
- Pneumococcal biliary tract infections are not rare, contrary to prior reports.
- The presence of biliary tract issues and devices is a significant risk factor for PBTI.
- PBTIs represent a notable proportion of pneumococcal bacteremia cases in specialized centers.
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