P2115 - Clinical and Laboratory Predictors of Bacteremic Cholangitis

Bashar Sharma, MD¹, Leen Z. Hasan, MD², Murali Dharan, MD^1
1University of Connecticut, Hartford, CT; ²University of Connecticut Health Center, Hartford, CT

Introduction: Biliary tract infection (BTI) is thought to be the second most common cause of sepsis in the elderly. Severe BTI characterized by blood stream infection may account for up to 20% of community acquired bacteremia in the elderly. Severe BTI is associated with increased risk of mortality and multi-organ failure.

Methods: A retrospective database analysis of the ERCP records at our institution from January 2018 to January 2021 was undertaken after IRB approval to identify clinical and laboratory parameters predictive of bacteremic cholangitis. Indications for ERCP were used to identify patients with suspected or definite cholangitis. The medical records of these patients were further analyzed and relevant clinical and laboratory data and ERCP findings were collected.

Results: Of a total of 300 patients who underwent ERCP, 24 patients met criteria for suspected or likely cholangitis. Complete data set was available in 23 patients. 10 of these patients had positive blood cultures consistent with bacteremic cholangitis. Clinical and laboratory parameters of these patients are summarized in Table 1.

Discussion: Preliminary findings from this limited retrospective study suggest older age, male sex, diabetes, hypertension and CHF are associated with increased risk of bacteremic cholangitis. WBC and total bilirubin appear to be higher in patients with bacteremic cholangitis. ALT elevation (but not other liver enzymes) was higher in bacteremic cholangitis. Pus extruding out of the ampulla (at ERCP) appears to correlate with increased risk of bacteremic cholangitis. These findings need to be validated by larger retrospective studies. It is unclear if early intervention in this subset of patients improves mortality and multi-organ failure.

Table: *One patient was 23 years of age which reduced the average age. Excluding this patient, the average age of the patients with bacteremic cholangitis was 77 years.


Disclosures:
Bashar Sharma indicated no relevant financial relationships.
Leen Hasan indicated no relevant financial relationships.
Murali Dharan indicated no relevant financial relationships.


Bashar Sharma, MD¹, Leen Z. Hasan, MD², Murali Dharan, MD¹. P2115 - Clinical and Laboratory Predictors of Bacteremic Cholangitis, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.