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©The Author(s) 2019.
World J Gastroenterol. Nov 7, 2019; 25(41): 6238-6247
Published online Nov 7, 2019. doi: 10.3748/wjg.v25.i41.6238
Published online Nov 7, 2019. doi: 10.3748/wjg.v25.i41.6238
Table 1 Surgical treatment data from 285 patients with pancreatic head resection
All patients, n = 285 (%) | With bacteriobilia (BB+), n = 150 (%) | Without bacteriobilia (BB-), n = 135 (%) | P value | |
Indications | ||||
Malignancy | n = 202 (71) | n = 114 (56)a | n = 88 (44) | < 0.05 |
cP1 | n = 51 (18) | n =23 (45) | n =28 (55) | 0.23 |
Others | n = 32 (11) | n =13 (41) | n =19 (59) | 0.15 |
Biliary drainage | ||||
PBD+ | n =144 (51) | n = 120 (83)b | n = 24 (17) | < 0.01 |
PBD- | n =141 (49) | n = 30 (21)b | n = 111 (79) | |
Cholestasis | ||||
PC+ | n = 120 (42) | n = 73 (61)c | n = 47 (39) | 0.02 |
PC- | n = 165 (58) | n = 77 (47)c | n = 88 (53) |
Table 2 Pathogen detection depending on horizontal drain (PBD+/PBD-) or presence of cholestasis (PC+/PC-)
Clinical group | Number of patients, (n) | Patients with bacterobilia, n (%) | Bacteria quantity, n | Fungi |
PBD-/PC-No stent/no cholestasis | 97 | 17 (18) | 24 | 0 |
PBD-/PC+No stent/cholestasis | 44 | 13 (30) | 22 | 2 |
PBD+/PC-Stent/no cholestasis | 68 | 60 (88) | 146 | 4 |
PBD+/PC+Stent/cholestase | 76 | 60 (80) | 150 | 9 |
All groups | 285 | 150 (53) | 342 |
Table 3 Bacterial profile in patients with bacteriobilia, (n = 150)
Patients with… | PBD-, n (%) | PBD+, n (%) | P value |
30 (20) | 120 (80) | ||
Polymicrobial mixed flora (n = 104) | 12 (40)d | 92 (78) | < 0.01 |
Enterococci (n = 82) | 9 (30)e | 73 (61) | < 0.05 |
Streptococci (n = 41) | 6 (20) | 35 (29) | 0.32 |
Klebsiella (n = 38) | 6 (20) | 32 (27) | 0.45 |
Escherichia (n = 35) | 8 (27) | 27 (23) | 0.60 |
Enterobacter (n = 21) | 1 (3) | 20 (17) | 0.06 |
Multi-drug resistant bacteria (n = 4) | 1 (3) | 3 (3) | 0.80 |
Table 4 Frequency of sensitivity and resistance compared to standard antibiotic prophylaxis with ampicillin-sulbactam in 342 bacteria
Ampicillin Sulbactam | Imipenem | Piperacillin Tazobactam | Ciprofloxacin | Moxifloxacin | Ceftriaxon | Cefuroxim | ||
PBD+ (n = 296) | Sensitivity | 174 (59) | 249 (84)e | 219 (74)e | 129 (44)e | 173 (58) | 147 (50)f | 126 (43)e |
Resistance | 81 (27) | 31 (11)e | 45 (15)e | 96 (32) | 49 (17)e | 62 (21)f | 115 (39)e | |
PBD- (n = 46) | Sensitivity | 31 (67) | 37 (80) | 33 (72) | 18 (39) + | 27 (59) | 23 (50)f | 24 (52) |
Resistance | 8 (17) | 7 (15) | 8 (17) | 15 (33) | 8 (17) | 13 (28) | 18 (39)f |
Table 5 Antimicrobial efficacy of ampicillin-sulbactam and piperacillin-tazobactam in direct comparison with 342 bacteria
Sensitivity (%) | Signifi-cance | Resistance (%) | Significance | ||||
AS | PT | P | AS | PT | P value | ||
TOP5(n = 256) | Enterococci (n = 97) | 71 | 70 | NS | 27 | 29 | NS |
Streptococci (n = 58) | 60g | 88 | < 0.01 | 0 | 0 | NS | |
Klebsiella (n = 43) | 86 | 98 | NS | 14h | 0 | 0.03 | |
Escherichia (n = 36) | 81g | 100 | < 0.01 | 19i | 0 | 0.02 | |
Enterobacter (n = 22) | 5g | 91 | < 0.01 | 95g | 0 | < 0.01 | |
Varia(n = 86) | Other genera | 40g | 80 | < 0.01 | 34g | 12 | < 0.01 |
- Citation: Krüger CM, Adam U, Adam T, Kramer A, Heidecke CD, Makowiec F, Riediger H. Bacterobilia in pancreatic surgery-conclusions for perioperative antibiotic prophylaxis. World J Gastroenterol 2019; 25(41): 6238-6247
- URL: https://www.wjgnet.com/1007-9327/full/v25/i41/6238.htm
- DOI: https://dx.doi.org/10.3748/wjg.v25.i41.6238