scholarly journals Predicting peritoneal contamination with enterobacteria producing extended-spectrum beta-lactamases and choosing empirical antibacterial therapy for postoperative peritonitis in cancer patients

2021 ◽  
Vol 60 (2) ◽  
pp. 4-8
Author(s):  
I. F. Shishlo ◽  
S. A. Krasny ◽  
Yu. N. Dolgina
Keyword(s):  
Risk Factors ◽  
Antibacterial Therapy ◽  
Predictive Accuracy ◽  
Postoperative Peritonitis ◽  
Empiric Antibiotic Therapy ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Peritoneal Contamination ◽  
Empirical Antibacterial Therapy ◽  
Extended Spectrum Beta Lactamases

Relevance: Enterobacteriaceae family microorganisms, specifically E. coli and K. pneumoniae isolates, are the most common activators of postoperative peritonitis in oncology. Many of these microorganisms produce extended-spectrum beta-lactamases (ESBL). The deemed resistance of ESBL-producing enterobacteria to all β-lactam antibiotics, except for carbapenems, leads to the ineffectiveness of empiric antibiotic therapy. The purpose of the study was to define the risk factors of peritoneal contamination with ESBL-producing enterobacteria for choosing optimal empirical antibacterial therapy on the example of a specific cancer patient with postoperative peritonitis. Results: Independent risk factors of peritoneal contamination with ESBL-producing enterobacteria included “the administration of antibiotics for more than three days” (OR 106, 95% CI 21.0-537, p<0.001), “two or more repeated laparotomies” (OR 2.66, 95% CI 1.32-5.34, p=0.006), and “postoperative preventive antibiotic treatment” (OR 0.17, 95% CI 0.04-0.75, p=0.02). The obtained prognostic model allowed predicting the infection with ESBL-producing enterobacteria before establishing the postoperative peritonitis microbial etiology. The model sensitivity was 94.7%, overall predictive accuracy was 73.1. Conclusion: Prolonged administration of antibiotics (3rd-generation cephalosporins and/or fluoroquinolones) after cancer surgery to prevent surgical infections is the main independent risk factor of peritoneal contamination with ESBL- producing enterobacteria.

scholarly journals Predicting peritoneal contamination with enterobacteria producing extendedspectrum beta-lactamases and choosing empirical antibacterial therapy for postoperative peritonitis in cancer patients

2021 ◽  
Vol 60 (2) ◽  
pp. 4-8
Author(s):  
I. F. Shishlo ◽  
S. A. Krasny ◽  
Yu. N. Dolgina
Keyword(s):  
Risk Factors ◽  
Antibacterial Therapy ◽  
Predictive Accuracy ◽  
Postoperative Peritonitis ◽  
Empiric Antibiotic Therapy ◽  
Beta Lactamases ◽  
Peritoneal Contamination ◽  
Empirical Antibacterial Therapy ◽  
Empiric Antibiotic ◽  
Extended Spectrum Beta Lactamases

Enterobacteriaceae family microorganisms, specifically E. coli and K. pneumoniae isolates, are the most common activators of postoperative peritonitis in oncology. Many of these microorganisms produce extended-spectrum beta-lactamases (ESBL). The deemed resistance of ESBL-producing enterobacteria to all β-lactam antibiotics, except for carbapenems, leads to ineffectiveness of empiric antibiotic therapy. Purpose of the study: To define the risk factors of peritoneal contamination with ESBL-producing enterobacteria for choosing optimal empirical antibacterial therapy on the example of a specific cancer patient with postoperative peritonitis. Results: Independent risk factors of peritoneal contamination with ESBL-producing enterobacteria included “the administration of antibiotics for more than three days” (OR 106, 95% CI 21.0-537, p<0.001), “two or more relaparotomies” (OR 2.66, 95% CI 1.32-5.34, p =0.006), and “postoperative preventive antibiotic treatment” (OR 0.17, 95% CI 0.04-0.75, p =0.02). The obtained prognostic model allowed predicting the infection with ESBL-producing enterobacteria before establishing the postoperative peritonitis microbial etiology. The model sensitivity was 94.7%, overall predictive accuracy was 73.1. Conclusion: Prolonged administration of antibiotics (3rd-generation cephalosporins and/or fluoroquinolones) after cancer surgery to prevent surgical infections is the main independent risk factor of peritoneal contamination with ESBL- producing enterobacteria.

scholarly journals Carriage of Enterobacteria Producing Extended-Spectrum β-Lactamases and Composition of the Gut Microbiota in an Amerindian Community

2015 ◽  
Vol 60 (1) ◽  
pp. 507-514 ◽  
Author(s):  
María José Gosalbes ◽  
Jorge F. Vázquez-Castellanos ◽  
Cécile Angebault ◽  
Paul-Louis Woerther ◽  
Etienne Ruppé ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gut Microbiota ◽  
Individual Risk ◽  
Content Type ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
Individual Risk Factors

ABSTRACTEpidemiological and individual risk factors for colonization by enterobacteria producing extended-spectrum beta-lactamases (E-ESBL) have been studied extensively, but whether such colonization is associated with significant changes in the composition of the rest of the microbiota is still unknown. To address this issue, we assessed in an isolated Amerindian Guianese community whether intestinal carriage of E-ESBL was associated with specificities in gut microbiota using metagenomic and metatranscriptomic approaches. While the richness of taxa of the active microbiota of carriers was similar to that of noncarriers, the taxa were less homogeneous. In addition, species of four genera,Desulfovibrio,Oscillospira,Parabacteroides, andCoprococcus, were significantly more abundant in the active microbiota of noncarriers than in the active microbiota of carriers, whereas such was the case only for species ofDesulfovibrioandOscillospirain the total microbiota. Differential genera in noncarrier microbiota could either be associated with resistance to colonization or be the consequence of the colonization by E-ESBL.

scholarly journals Clinical and Molecular Characterization of Community-Onset Urinary Tract Infections Due to Extended-Spectrum Cephalosporin-Resistant Enterobacteriaceae

2016 ◽  
Vol 37 (12) ◽  
pp. 1433-1439 ◽  
Author(s):  
Judith A. Anesi ◽  
Ebbing Lautenbach ◽  
Irving Nachamkin ◽  
Charles Garrigan ◽  
Warren B. Bilker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Older Age ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
Tract Infections ◽  
Community Onset

OBJECTIVETo evaluate risk factors for and molecular characteristics of community-onset extended-spectrum cephalosporin-resistant (ESC-R) Enterobacteriaceae (EB) urinary tract infections (UTIs) in a US health system.DESIGNCase-control study.PARTICIPANTSAll patients presenting to the emergency department or outpatient practices with EB UTIs from December 21, 2010, through April 22, 2013, were included. Case patients had ESC-R EB UTIs. Control patients had ESC-susceptible EB UTIs and were matched 1:1 on study year.METHODSRisk factors for ESC-R EB UTI were assessed using multivariable conditional logistic regression. A subset of case isolates was evaluated for extended-spectrum beta-lactamases.RESULTSA total of 302 patients with community-onset EB UTI were included, of which 151 were cases. On multivariable analysis, risk factors for ESC-R EB UTI included trimethoprim-sulfamethoxazole use in the prior 6 months (odds ratio, 2.40 [95% CI, 1.22–4.70];P=.01), older age (1.03 [1.01–1.04];P<.001), diabetes (2.91 [1.32–6.41];P=.008), and presentation to the emergency department ( 2.42 [1.31–4.46];P=.005). The prevalence of extended-spectrum beta-lactamases among 120 case isolates was 52% CTX-M, 29% TEM, 20% OXA, and 13% SHV. The prevalence of AmpC was 25%. Pulsed-field gel electrophoresis of the CTX-MEscherichia coliisolates showed no distinct clusters.CONCLUSIONSUse of trimethoprim-sulfamethoxazole, older age, diabetes, and presentation to the emergency department were associated with community-onset ESC-R EB UTI. There was a high prevalence of CTX-M among our community isolates. Further studies are needed to determine strategies to limit emergence of these organisms in the community.Infect Control Hosp Epidemiol2016;1433–1439

scholarly journals Risk Factors of Extended-Spectrum Beta-Lactamases-Producing Escherichia coli Community Acquired Urinary Tract Infections: A Systematic Review

2020 ◽  
Vol Volume 13 ◽  
pp. 3945-3955
Author(s):  
Stéphanie Larramendy ◽  
Valentine Deglaire ◽  
Paul Dusollier ◽  
Jean-Pascal Fournier ◽  
Jocelyne Caillon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Systematic Review ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
Tract Infections
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