The frequency and features of cholangitis following Kasai portoenterostomy (KPE) in individuals with biliary atresia were studied. Researchers also investigated the distribution and antibiotic susceptibility patterns of the causal bacteria, which were identified in sterile material, such as blood and ascites. From 2006-2015, a retrospective record analysis was done on patients with biliary atresia who received KPE at Severance Children’s Hospital in Korea. To calculate the cumulative incidence of cholangitis, the Kaplan-Meier technique was employed. During the research period, there were 494 occurrences of cholangitis in 126 of the 160 enrolled patients. At 1 and 5 years following KPE, the cumulative incidence of cholangitis was 75.5 percent and 84.2 percent, respectively, and cholangitis recurred in the majority of patients. At 1 and 5 years following KPE, the cumulative incidence of culture-proven cholangitis was 22.1 percent and 23.9 percent, respectively. The most common pathogen was Enterococcus faecium, which was followed by Escherichia coli, Enterobacter cloacae, and Klebsiella pneumoniae. Gram-positive infections were resistant to ampicillin and gentamicin, whereas only 38.1 percent of Gram-negative isolates were resistant to cefotaxime.
The current study is the largest to demonstrate the high frequency and features of cholangitis following KPE in biliary atresia patients. Enterococcus is a frequent pathogen causing cholangitis following KPE and should be taken into account when selecting empiric antibiotic treatment.
