Reuken, P. A. and Kruis, W. and Maaser, C. and Teich, N. and Buening, J. and Preiss, J. C. and Schmelz, R. and Bruns, T. and Fichtner-Feigl, S. and Stallmach, A. (2018) Microbial Spectrum of Intra-Abdominal Abscesses in Perforating Crohn's Disease: Results from a Prospective German Registry. JOURNAL OF CROHNS & COLITIS, 12 (6). pp. 695-701. ISSN 1873-9946, 1876-4479
Full text not available from this repository. (Request a copy)Abstract
Background: Intra-abdominal abscesses [IAAs] are common life-threatening complications in patients with Crohn's disease [CD]. In addition to interventional drainage and surgical therapy, empirical antibiotic therapy represents a cornerstone of treatment, but contemporary data on microbial spectra and antimicrobial resistance are scarce. Methods: We recruited 105 patients with CD and IAAs from nine German centres for a prospective registry in order to characterize the microbiological spectrum, resistance profiles, antibiotic therapy and outcome. Results: In 92 of 105 patients, microbial investigations of abscess material revealed pathogenic microorganisms. A total of 174 pathogens were isolated, with a median of 2 pathogens per culture [range: 1-6]. Most frequently isolated pathogens were E. coli [45 patients], Streptococcus spp. [28 patients], Enterococci [27 patients], Candida [13 patients] and anaerobes [12 patients]. Resistance to third-generation cephalosporins, penicillins with beta-lactamase inhibitors and quinolones were observed in 51, 36 and 35 patients, respectively. Seven patients had multiple-drug-resistant bacteria. Thirty patients received inadequate empirical treatment, and this was more frequent in patients receiving steroids or immunosuppression [37%] than in patients without immunosuppression [10%: p = 0.001] and was associated with a longer hospital stay [21 days vs 13 days, p = 0.003]. Conclusion: Based on antimicrobial resistance profiles, we herein report a high rate of inadequate empirical first-line therapy for IAAs in CD, especially in patients receiving immunosuppression, and this is associated with prolonged hospitalization.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SPONTANEOUS BACTERIAL PERITONITIS; INTENSIVE-CARE-UNIT; ANTIBIOTIC-RESISTANCE; PERCUTANEOUS DRAINAGE; SECONDARY PERITONITIS; CONSECUTIVE PATIENTS; PELVIC ABSCESS; SEPTIC SHOCK; RISK-FACTORS; INFECTIONS; Microbial spectrum; intra-abdominal abscess [IAA]; perforating Crohn's disease; antimicrobial resistance |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 17 Feb 2020 13:45 |
| Last Modified: | 17 Feb 2020 13:45 |
| URI: | https://pred.uni-regensburg.de/id/eprint/14498 |
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