WP5.1 - An audit of Escherichia coli bacteraemia from a hepatobiliary origin Free

Gallstone disease is the commonest cause of biliary sepsis, which in turn is a frequent source of Escherichia coli bacteraemia (ECB). In 2022, our health board was an outlier for ECB infection rates. It was hypothesized that this may be related to extended waiting times to be seen at the surgical clinic or rising numbers on the waiting list for cholecystectomy, caused by the COVID-19 backlogs. This study aims to assess the prevalence and characteristics of ECB infections associated with hepatobiliary conditions in a tertiary centre in Scotland, and review any associations with waiting lists.

A retrospective analysis of ECB cases linked to hepatobiliary conditions between 01/01/2022 and 31/12/2022 was conducted. Parameters studied included infection acquisition (community, hospital, healthcare-associated), biliary disease history, inpatient/outpatient status, waiting list status, admission specialty and treatment modalities.

Of the 71 cases analysed, 68% were community-acquired, while only 15% were healthcare or hospital-associated. Non-malignant biliary disease was present in 43% of patients, and 39% had prior inpatient history. The majority were not on clinic (89%) or surgery (92%) waiting lists. General surgery was the commonest admitting speciality (51%). Mortality rate was 17%.

This audit did not identify an association between increases in ECB rates and waiting lists for clinic review or surgery, and very few patients were awaiting cholecystectomy. The study confirms the clinical significance of hepatobiliary-associated ECB infection, with mortality rates similar to that of previously published reports.