title: Sustained bacteremia associated with transjugular intrahepatic portosystemic shunt (TIPS).
abstract: Transjugular intrahepatic portosystemic shunt (TIPS) has become a routine procedure in patients with portal hypertension, yet there are few data concerning the incidence of bacteremia associated with this shunt. All patients who underwent TIPS placement at a university hospital from January 1992 through January 1999 were studied. Ninety-nine TIPS were placed, and 10 patients subsequently developed sustained bacteremia; 5 patients had no identifiable source of bacteremia despite rigorous evaluation and were presumed to represent TIPS infections, for an estimated annual incidence of 7 cases/1000 TIPS procedures. Case patients developed bacteremia a median of 100 days after TIPS placement (range, 6-732 days). Bacteremia resolved in all patients after treatment with appropriate intravenous antibiotics (median, 2 weeks of therapy). Although the incidence of TIPS-associated bacteremia appears low, the increasing frequency of this procedure suggests that more information is needed to define this entity and to develop appropriate treatment recommendations.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Thomas Jefferson University, Philadelphia, PA 19107, USA. joseph.desimone@mail.tju.edu
authors.forename: J A
authors.initials: JA
authors.lastname: DeSimone
authors.forename: K G
authors.initials: KG
authors.lastname: Beavis
authors.forename: D J
authors.initials: DJ
authors.lastname: Eschelman
authors.forename: K J
authors.initials: KJ
authors.lastname: Henning
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015143:Philadelphia / Q000453:epidemiology; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects*; D012042:Registries; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents