UEG's educational platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

UEG Week Berlin 2025 Recordings Gut Guide online

Rate for better recommendations!

Your feedback helps us show you more of what you like and less of what you dislike!

More of this!

We will show you more similar content.

Not for me!

We won't suggest this again.

Bookmark!

Save this content for later!

New to myUEG? Create an account! Log In with myUEG account

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

THE SPECTRUM OF MICROORGANISMS IS ASSOCIATED WITH THE OUTCOMES OF ENDOSONOGRAPHY-GUIDED THERAPY FOR INFECTED PANCREATIC FLUID COLLECTIONS

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

THE SPECTRUM OF MICROORGANISMS IS ASSOCIATED WITH THE OUTCOMES OF ENDOSONOGRAPHY-GUIDED THERAPY FOR INFECTED PANCREATIC FLUID COLLECTIONS

Marcel Razpotnik 1, Christian Jürgensen 1, Michael Sigal 1, Christos Makris 1, Felix Johannes Körner 1, Theresa Maria Holtmann 1, Özlem Celebi 1, Andreas Adler 1, Federica Branchi 1, Juliane Buchkremer 1, Frank Tacke 1, Alexander Wree 1

Affiliations

1 Charité - Universitätsmedizin Berlin, Berlin, Germany

Summary

AI Generated

In EUS-guided drainage of infected pancreatic fluid collections, the infecting microorganism significantly impacts outcomes, with Enterococcus faecium infections associated with 29.4% mortality (OR 8.1) and Enterococcus faecalis infections linked to poor collection resolution (33.3% vs. 88% in controls).

This retrospective study from three Charité Berlin endoscopy units (2018-2022) analyzed 102 patients (58 infected, 44 non-infected controls) undergoing EUS-guided drainage of pancreatic fluid collections with double pigtail plastic stents (89.2%) and necrosectomy (37.3%).
Enterococcus faecium infections (n=17, including 4 vancomycin-resistant cases) resulted in significantly higher mortality of 29.4% versus 4.5% in controls (p<0.05), with an odds ratio of 8.1 (95% CI 1.4-47.4) in multivariate analysis.
Enterococcus faecalis infections (n=6) were associated with significantly worse clinical outcomes, with only 33.3% achieving collection resolution versus 88% in controls (p<0.05) and a median hospital stay of 93 days.
Gram-positive infections (n=42) required significantly longer hospitalization (32 vs. 21 days, p<0.001) and ICU stay (49 vs. 2 days, p<0.001) compared to non-infected controls.
Candida glabrata infections showed lower endoscopic therapy success rates (45.5% resolution) compared to Candida albicans infections (85.4% resolution).
The authors conclude that organism type significantly impacts outcomes and emphasize the need for targeted therapeutic strategies in the context of rising antimicrobial resistance.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Previous studies have demonstrated that infected pancreatic fluid collections are associated with worse clinical outcomes¹.

Aims & Methods

In light of the global rise in antibiotic resistance, this study investigates the impact of the spectrum of infecting microorganisms on the effectiveness of endosonography (EUS)-guided drainage for these conditions. Data on EUS-guided drainage of pancreatic fluid collections performed between 2018 and 2022 at three endoscopy units of Charité Berlin, regardless of the etiology, were reviewed and analyzed. The primary- endpoints were the duration of hospital stay and clinical success of the therapeutic EUS, defined as (1) the resolution of the collection to <50% within 1-3 months as observed in follow-up imaging and (2) clinical improvement. The secondary endpoints were the duration of ICU stay, mortality, and the total number of required interventions to achieve treatment success, including the initial intervention, removal and replacement of stents, and additional procedures, e.g., necrosectomy or therapy of complications during 12 months follow-up. The infection of the fluid collection was diagnosed based on microbiological evidence obtained from EUS-guided fine needle aspiration or positive blood culture, after excluding other sources of infection, along with clinical presentation and elevated inflammatory markers. The microorganisms were categorized based on microscopic appearance, Gram staining, and the number of germs in a collection. Patients with sterile necrotic collections undergoing the same therapeutic modality were used as a control group to compare the outcomes.

Results

A total of 102 patients (71.6% male, mean age 55.9±13.9 years) were included in the final analysis. In 91 of the 102 cases (89.2%), double pigtail plastic stents were utilized (46.1% were multiple), and in 38 (37.3%) patients, a transmural endoscopic necrosectomy was performed. In 29.5% of cases, penicillin; 18.2%, carbapenems; 13.6%, cephalosporins; 6.8%, metronidazole; 6.8%, vancomycin; and 18.2%, other antibiotics were administered. Compared to the control group, Gram-positive germs were associated with a significantly longer hospital stay (32 vs. 21 days, p < 0.001 ) and a greater need for ICU services (49 vs. 2 days, p < 0.001). Endoscopic therapy was less successful for Candida glabrata infections compared to those caused by Candida albicans (45.5% vs. 85.4%). While both were associated with a significantly prolonged hospital stay, infections with Enterococcus faecium (including 4 cases of vancomycin-resistant Enterococcus faecium, VRE) resulted in significantly higher mortality (29.4% vs. 4.5%, p < 0.05), and infections with Enterococcus faecalis were associated with significantly worse clinical outcomes as defined by the resolution of the collection in follow-up assessments (33.3% vs. 88%, p < 0.05). These correlations remained significant in the multivariate regression analysis, with Enterococcus faecium showing an odds ratio (OR) of 8.1 (95% CI: 1.4–47.4) for higher mortality.

	Number (%)	Hospital (days)	ICU (days)	Interventions (n)	Resolution (%)	Outcome (%)	Mortality (%)
Non-infected (control) Infected	44 (43.1) 58(56.9)	21 (1-71) 23 (1-243)*	2 (1-60) 15 (1-186)*	3 (1-8) 5 (2-21)*	100 (14.3-100) 81.4 (22.5-100)	88 75.8	4.5 12.1
Gram-positive Gram-negative Mixed infections	42 (41.2) 22 (21.6) 39 (38.2)	32 (1-243)** 29.5 (7-243)* 27.5 (1-243)*	49 (2-186)** 49 (1-107)* 49 (1-143)*	5 (2-21)* 5 (2-11)* 5 (2-21)*	70.8 (22.5-100) 100 (32.3-100) 81.2 (22.5-100)	69.6 76.9 73.9	14.3 13.6 12.8
*Enterococcus faecium* *Enterococcus faecalis* *Candida albicans* *Candida glabrata* *Streptococcus spp.* *Klebsiella pneumoniae* *Escherichia coli* Others	17 (16.7) 6 (5.9) 18 (17.6) 7 (6.9) 13 (12.7) 8 (7.8) 5 (4.9) 22 (21.6)	34 (6-210) 93 (62-210) 20 (4-205) 34 (6-169) 10 (1-28)* 26 (12-107) 35 (7-107) 47.5 (9-243)**	36 (3-186)* 61.5 (7-92)* 9 (1-143) 16 (7-74)* 9 42 (9-92) 59 (1-92) 16 (2-143)*	6 (2-21) 8 (3-12)* 3.5 (2-11) 6.5 (2-20) 5 (3-5)* 3 (2-6) 6 5.5 (2-21)*	83.5 (22.5-100) 60.0 (32.3-69.2)* 85.4 (32.3-100) 45.5 (22.5-83.8)* 78.9 (63.0-100) 100 (32.3-100) 100 (32.3-100) 79.2 (32.3-100)	62.5 33.3* 76.9 50 100 80 75 76.9	29.4* 16.7 5.9 28.6 0 12.5 0 13.6
Compared to non-infected: p <0.05, *p<0.001

Conclusion

The type of infecting organism significantly impacts clinical outcomes in patients undergoing EUS-guided drainage for infected peripancreatic fluid collections. Enterococcus faecalis and faecium infections were associated with poorer clinical outcomes, highlighting the need for targeted therapeutic strategies.

References

1. Werge M, Novovic S, Schmidt PN, Gluud LL. Infection increases mortality in necrotizing pancreatitis: A systematic review and meta-analysis. Pancreatology. 2016 Sep-Oct;16(5):698-707.

Disclosure

No conflict of interest.

Event

UEG Week Vienna 2024

Topics

Gut Microbiota IBD Pancreas

Submission format

Abstract

Session

What's new in acute pancreatitis

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

More Like This:

Managing pancreatic duct pressure: Early intervention vs. step-up strategies. Pros and cons for safer outcomes

Jayanta Samanta

CCC: Molecular targeted therapies

Arndt Vogel

Video Case: Management of pancreatic stones and strictures: Endoscopy vs surgery

Tobias Keck

Novel aspects of the updated german pancreatic cancer guideline

Thomas Seufferlein

... for medical therapy in colorectal cancer

Sebastian Foersch

ROLE AND MECHANISM OF PDLIM2 GENE MUTATION IN PROMOTING HYPERTRIGLYCERIDEMIA ACUTE PANCREATITIS

Song He

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Managing pancreatic duct pressure: Early intervention vs. step-up strategies. Pros and cons for safer outcomes

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Managing pancreatic duct pressure: Early intervention vs. step-up strategies. Pros and cons for safer outcomes

Marco J. Bruno 1, Jayanta Samanta 2

Affiliations

1 Eramus University Medical Centre, Rotterdam, Netherlands

2 Post Graduate Institute of Medical Education and Research, Chandigarh, Kolkata, India

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Event

UEG Week Berlin 2025

Session

Therapy update: Acute severe pancreatitis – It's all about timing!

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Managing pancreatic duct pressure: Early intervention vs. step-up strategies. Pros and cons for safer outcomes

Jayanta Samanta

CCC: Molecular targeted therapies

Arndt Vogel

Video Case: Management of pancreatic stones and strictures: Endoscopy vs surgery

Tobias Keck

Novel aspects of the updated german pancreatic cancer guideline

Thomas Seufferlein

... for medical therapy in colorectal cancer

Sebastian Foersch

ROLE AND MECHANISM OF PDLIM2 GENE MUTATION IN PROMOTING HYPERTRIGLYCERIDEMIA ACUTE PANCREATITIS

Song He

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

CCC: Molecular targeted therapies

Arndt Vogel 1

Affiliations

1 Medizin. Hochschule Hannover, Hannover, Canada

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Event

UEG Week Berlin 2025

Topics

Digestive Oncology Hepatobiliary Mechanisms & Personalised Medicine Radiology & Imaging

Session

Advancement in management of primary liver tumors

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Managing pancreatic duct pressure: Early intervention vs. step-up strategies. Pros and cons for safer outcomes

Jayanta Samanta

CCC: Molecular targeted therapies

Arndt Vogel

Video Case: Management of pancreatic stones and strictures: Endoscopy vs surgery

Tobias Keck

Novel aspects of the updated german pancreatic cancer guideline

Thomas Seufferlein

... for medical therapy in colorectal cancer

Sebastian Foersch

ROLE AND MECHANISM OF PDLIM2 GENE MUTATION IN PROMOTING HYPERTRIGLYCERIDEMIA ACUTE PANCREATITIS

Song He

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Video Case: Management of pancreatic stones and strictures: Endoscopy vs surgery

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Video Case: Management of pancreatic stones and strictures: Endoscopy vs surgery

Marco J. Bruno 1, Tobias Keck 2

Affiliations

1 University Medical Center Rotterdam, Rotterdam, Netherlands

2 UKSH Universitätsklinikum Schleswig-Holstein, Lübeck, Germany

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Event

UEG Postgraduate Teaching Programme Vienna 2024

Topics

Education & Training Endoscopy Pancreas Surgery

Session

Management of pancreatic diseases: Knife or scope?

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

More Like This:

Managing pancreatic duct pressure: Early intervention vs. step-up strategies. Pros and cons for safer outcomes

Jayanta Samanta

CCC: Molecular targeted therapies

Arndt Vogel

Video Case: Management of pancreatic stones and strictures: Endoscopy vs surgery

Tobias Keck

Novel aspects of the updated german pancreatic cancer guideline

Thomas Seufferlein

... for medical therapy in colorectal cancer

Sebastian Foersch

ROLE AND MECHANISM OF PDLIM2 GENE MUTATION IN PROMOTING HYPERTRIGLYCERIDEMIA ACUTE PANCREATITIS

Song He

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Novel aspects of the updated german pancreatic cancer guideline

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Novel aspects of the updated german pancreatic cancer guideline

Thomas Seufferlein 1

Affiliations

1 Universitätsklinikum Ulm - Klinik für Innere Medizin I, Ulm, Germany

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Event

UEG Week Vienna 2024

Topics

Hepatobiliary Pancreas Standards & Guidelines

Session

From guidelines to clinical practice: HPB

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

More Like This:

Managing pancreatic duct pressure: Early intervention vs. step-up strategies. Pros and cons for safer outcomes

Jayanta Samanta

CCC: Molecular targeted therapies

Arndt Vogel

Video Case: Management of pancreatic stones and strictures: Endoscopy vs surgery

Tobias Keck

Novel aspects of the updated german pancreatic cancer guideline

Thomas Seufferlein

... for medical therapy in colorectal cancer

Sebastian Foersch

ROLE AND MECHANISM OF PDLIM2 GENE MUTATION IN PROMOTING HYPERTRIGLYCERIDEMIA ACUTE PANCREATITIS

Song He

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

... for medical therapy in colorectal cancer

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

... for medical therapy in colorectal cancer

Sebastian Foersch 1

Affiliations

1 University Medical Center Mainz, Mainz, Germany

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Event

UEG Week Berlin 2025

Topics

Colorectal IBD Surgery

Session

Predicting patient outcomes...

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Managing pancreatic duct pressure: Early intervention vs. step-up strategies. Pros and cons for safer outcomes

Jayanta Samanta

CCC: Molecular targeted therapies

Arndt Vogel

Video Case: Management of pancreatic stones and strictures: Endoscopy vs surgery

Tobias Keck

Novel aspects of the updated german pancreatic cancer guideline

Thomas Seufferlein

... for medical therapy in colorectal cancer

Sebastian Foersch

ROLE AND MECHANISM OF PDLIM2 GENE MUTATION IN PROMOTING HYPERTRIGLYCERIDEMIA ACUTE PANCREATITIS

Song He

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

ROLE AND MECHANISM OF PDLIM2 GENE MUTATION IN PROMOTING HYPERTRIGLYCERIDEMIA ACUTE PANCREATITIS

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

ROLE AND MECHANISM OF PDLIM2 GENE MUTATION IN PROMOTING HYPERTRIGLYCERIDEMIA ACUTE PANCREATITIS

Li Xiaoqin 1, Huize Li 1, Qin Tang 1, Song He 1, Zhihang Zhou 1

Affiliations

1 The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Introduction

Acute pancreatitis (AP) is an acute inflammatory autodigestive disorder triggered by dysfunction of pancreatic exocrine activity and represents the most common gastrointestinal emergency in clinical practice. Global data indicate an annual incidence rate of 33.74 per 100,000 population and a mortality rate of 1.16 per 100,000. Despite ongoing optimization of therapeutic strategies, current clinical management primarily relies on supportive care and surgery. Hypertriglyceridemia (HTG) is the second leading etiological factor for AP, accounting for 10.36% of cases. Compared to other causes, HTG-associated acute pancreatitis (HTG-AP) exhibits higher recurrence rates and more severe complications (e.g., pancreatic necrosis and renal insufficiency). With the rising prevalence of HTG, the disease burden of HTG-AP is increasing, yet its specific pathogenic mechanisms remain unclear.

Aims & Methods

This study integrated whole-genome sequencing (WGS) and next-generation sequencing (NGS) to screen for shared mutations in the exonic regions of 5 HTG-AP family members. Candidate genes were identified based on MutationTaster classification and CADD scores. A mouse model carrying the PDLIM2 gene rs145349678 mutation was constructed using CRISPR/Cas9 technology, and an HTG-AP animal model was established. Pancreatic and hepatic histopathology (HE staining) and serological markers (TG, lipase, amylase, IL-6) were analyzed to evaluate the impact of the mutation on pancreatitis severity and hepatic lipid deposition.

Results

A clinical HTG-AP family was identified, with all 5 members exhibiting hypertriglyceridemia, including 2 cases of recurrent pancreatitis. WGS revealed 278 mutation sites across 10 chromosomes (involving 23 genes) in the family, and NGS validation narrowed these to 7 candidate loci. The PDLIM2 rs145349678 mutation (NM_001368120.1:exon9:c.C1055T:p.A352V), located within the LIM domain (which mediates protein localization and signaling transduction), was selected as the target due to cross-species conservation. Experimental results demonstrated that HTG-AP mice with the PDLIM2 mutation exhibited significantly aggravated pancreatic pathological damage (edema, hemorrhage, and inflammatory cell infiltration; *P* < 0.05), elevated serological markers (TG: 2.3 ± 0.4 vs. 1.5 ± 0.3 mmol/L; lipase: 520 ± 68 vs. 320 ± 45 U/L; IL-6: 48.2 ± 6.1 vs. 28.5 ± 4.3 pg/mL; *P* < 0.01 for all), and a 2.3-fold increase in hepatic lipid deposition (*P* < 0.001) compared to controls.

Conclusion

The PDLIM2 rs145349678 mutation exacerbates inflammatory responses and hepatic lipid accumulation in HTG-AP by modulating lipid metabolism. This finding provides new insights into the pathogenesis of HTG-AP and potential therapeutic targets.

Event

UEG Week Berlin 2025

Topics

Mechanisms & Personalised Medicine Pancreas

Submission format

Abstract

Session

Cogulation, lipids and bugs: All relevant for pancreatitis

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Managing pancreatic duct pressure: Early intervention vs. step-up strategies. Pros and cons for safer outcomes

Jayanta Samanta

CCC: Molecular targeted therapies

Arndt Vogel

Video Case: Management of pancreatic stones and strictures: Endoscopy vs surgery

Tobias Keck

Novel aspects of the updated german pancreatic cancer guideline

Thomas Seufferlein

... for medical therapy in colorectal cancer

Sebastian Foersch

ROLE AND MECHANISM OF PDLIM2 GENE MUTATION IN PROMOTING HYPERTRIGLYCERIDEMIA ACUTE PANCREATITIS

Song He

UEG's educational platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

Most popular content

Rate for better recommendations!