Consequences of Increases in Antibiotic Resistance Pattern on Outcome of Pancreatic Resection for Cancer

Luca Gianotti, Nicolò Tamini, Francesca Gavazzi, Anna Mariani, Marta Sandini, Fabio Ferla, Marco Cereda, Giovanni Capretti, Stefano Di Sandro, Davide Paolo Bernasconi, Luciano De Carlis, Alessandro Zerbi

Research output: Contribution to journalArticle

Abstract

Background: The role of drug-resistance infections on surgical outcomes is controversial. The aim of the study was to determine whether increase antibiotic resistance was an independent risk factor for development of major non-infectious postoperative complications. Methods: This work included a multicenter cohort study of patients who underwent pancreatic resections for cancer over a 3-year interval. The primary outcome was major non-infectious complication rate developing after the occurrence of multi-drug sensitive (MDS) infection, multi-drug-resistant infection (MDR), and extensive drug-resistant (XDR) infection. Multivariate logistic regression models were used to adjust for patient and operative effects. Results: Eligible patients (517) were selected for the analysis. One hundred and thirteen (21.8%) patients had major non-infectious complications with a rate of 12.9% in the no infection group, 29.3% in the MSD, 41.5% in the MDR, and 58.8% in the XDR (p < 0.001). The median time of infection occurrence was postoperative days 4 (2–7 IQR) and 7 (3–12 IQR) non-infectious complications. At multivariate analysis, the risk of having major non-infectious complications was 2.67 (95% CI 1.24–5.77, P = 0.012) for MDR, 5.04 (95% CI 2.35–10.80, P < 0.001) for MDR, and 9.64 (95% CI 2.71–34.28, P < 0.001) for XDR. Conclusion: Antimicrobial resistance is significantly associated with the risk of major non-infectious morbidity.

Original languageEnglish
Pages (from-to)1650-1657
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume21
Issue number10
DOIs
Publication statusPublished - Oct 1 2017

Fingerprint

Microbial Drug Resistance
Pancreatic Neoplasms
Infection
Pharmaceutical Preparations
Logistic Models
Drug Resistance
Multicenter Studies
Cohort Studies
Multivariate Analysis
Morbidity

Keywords

  • Complications
  • Drug-resistance
  • Outcome
  • Pancreas
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Consequences of Increases in Antibiotic Resistance Pattern on Outcome of Pancreatic Resection for Cancer. / Gianotti, Luca; Tamini, Nicolò; Gavazzi, Francesca; Mariani, Anna; Sandini, Marta; Ferla, Fabio; Cereda, Marco; Capretti, Giovanni; Di Sandro, Stefano; Bernasconi, Davide Paolo; De Carlis, Luciano; Zerbi, Alessandro.

In: Journal of Gastrointestinal Surgery, Vol. 21, No. 10, 01.10.2017, p. 1650-1657.

Research output: Contribution to journalArticle

Gianotti, L, Tamini, N, Gavazzi, F, Mariani, A, Sandini, M, Ferla, F, Cereda, M, Capretti, G, Di Sandro, S, Bernasconi, DP, De Carlis, L & Zerbi, A 2017, 'Consequences of Increases in Antibiotic Resistance Pattern on Outcome of Pancreatic Resection for Cancer', Journal of Gastrointestinal Surgery, vol. 21, no. 10, pp. 1650-1657. https://doi.org/10.1007/s11605-017-3483-1
Gianotti, Luca ; Tamini, Nicolò ; Gavazzi, Francesca ; Mariani, Anna ; Sandini, Marta ; Ferla, Fabio ; Cereda, Marco ; Capretti, Giovanni ; Di Sandro, Stefano ; Bernasconi, Davide Paolo ; De Carlis, Luciano ; Zerbi, Alessandro. / Consequences of Increases in Antibiotic Resistance Pattern on Outcome of Pancreatic Resection for Cancer. In: Journal of Gastrointestinal Surgery. 2017 ; Vol. 21, No. 10. pp. 1650-1657.
@article{fc9f57f6cb774294b9064222d776be75,
title = "Consequences of Increases in Antibiotic Resistance Pattern on Outcome of Pancreatic Resection for Cancer",
abstract = "Background: The role of drug-resistance infections on surgical outcomes is controversial. The aim of the study was to determine whether increase antibiotic resistance was an independent risk factor for development of major non-infectious postoperative complications. Methods: This work included a multicenter cohort study of patients who underwent pancreatic resections for cancer over a 3-year interval. The primary outcome was major non-infectious complication rate developing after the occurrence of multi-drug sensitive (MDS) infection, multi-drug-resistant infection (MDR), and extensive drug-resistant (XDR) infection. Multivariate logistic regression models were used to adjust for patient and operative effects. Results: Eligible patients (517) were selected for the analysis. One hundred and thirteen (21.8{\%}) patients had major non-infectious complications with a rate of 12.9{\%} in the no infection group, 29.3{\%} in the MSD, 41.5{\%} in the MDR, and 58.8{\%} in the XDR (p < 0.001). The median time of infection occurrence was postoperative days 4 (2–7 IQR) and 7 (3–12 IQR) non-infectious complications. At multivariate analysis, the risk of having major non-infectious complications was 2.67 (95{\%} CI 1.24–5.77, P = 0.012) for MDR, 5.04 (95{\%} CI 2.35–10.80, P < 0.001) for MDR, and 9.64 (95{\%} CI 2.71–34.28, P < 0.001) for XDR. Conclusion: Antimicrobial resistance is significantly associated with the risk of major non-infectious morbidity.",
keywords = "Complications, Drug-resistance, Outcome, Pancreas, Surgery",
author = "Luca Gianotti and Nicol{\`o} Tamini and Francesca Gavazzi and Anna Mariani and Marta Sandini and Fabio Ferla and Marco Cereda and Giovanni Capretti and {Di Sandro}, Stefano and Bernasconi, {Davide Paolo} and {De Carlis}, Luciano and Alessandro Zerbi",
year = "2017",
month = "10",
day = "1",
doi = "10.1007/s11605-017-3483-1",
language = "English",
volume = "21",
pages = "1650--1657",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
publisher = "Springer New York LLC",
number = "10",

}

TY - JOUR

T1 - Consequences of Increases in Antibiotic Resistance Pattern on Outcome of Pancreatic Resection for Cancer

AU - Gianotti, Luca

AU - Tamini, Nicolò

AU - Gavazzi, Francesca

AU - Mariani, Anna

AU - Sandini, Marta

AU - Ferla, Fabio

AU - Cereda, Marco

AU - Capretti, Giovanni

AU - Di Sandro, Stefano

AU - Bernasconi, Davide Paolo

AU - De Carlis, Luciano

AU - Zerbi, Alessandro

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Background: The role of drug-resistance infections on surgical outcomes is controversial. The aim of the study was to determine whether increase antibiotic resistance was an independent risk factor for development of major non-infectious postoperative complications. Methods: This work included a multicenter cohort study of patients who underwent pancreatic resections for cancer over a 3-year interval. The primary outcome was major non-infectious complication rate developing after the occurrence of multi-drug sensitive (MDS) infection, multi-drug-resistant infection (MDR), and extensive drug-resistant (XDR) infection. Multivariate logistic regression models were used to adjust for patient and operative effects. Results: Eligible patients (517) were selected for the analysis. One hundred and thirteen (21.8%) patients had major non-infectious complications with a rate of 12.9% in the no infection group, 29.3% in the MSD, 41.5% in the MDR, and 58.8% in the XDR (p < 0.001). The median time of infection occurrence was postoperative days 4 (2–7 IQR) and 7 (3–12 IQR) non-infectious complications. At multivariate analysis, the risk of having major non-infectious complications was 2.67 (95% CI 1.24–5.77, P = 0.012) for MDR, 5.04 (95% CI 2.35–10.80, P < 0.001) for MDR, and 9.64 (95% CI 2.71–34.28, P < 0.001) for XDR. Conclusion: Antimicrobial resistance is significantly associated with the risk of major non-infectious morbidity.

AB - Background: The role of drug-resistance infections on surgical outcomes is controversial. The aim of the study was to determine whether increase antibiotic resistance was an independent risk factor for development of major non-infectious postoperative complications. Methods: This work included a multicenter cohort study of patients who underwent pancreatic resections for cancer over a 3-year interval. The primary outcome was major non-infectious complication rate developing after the occurrence of multi-drug sensitive (MDS) infection, multi-drug-resistant infection (MDR), and extensive drug-resistant (XDR) infection. Multivariate logistic regression models were used to adjust for patient and operative effects. Results: Eligible patients (517) were selected for the analysis. One hundred and thirteen (21.8%) patients had major non-infectious complications with a rate of 12.9% in the no infection group, 29.3% in the MSD, 41.5% in the MDR, and 58.8% in the XDR (p < 0.001). The median time of infection occurrence was postoperative days 4 (2–7 IQR) and 7 (3–12 IQR) non-infectious complications. At multivariate analysis, the risk of having major non-infectious complications was 2.67 (95% CI 1.24–5.77, P = 0.012) for MDR, 5.04 (95% CI 2.35–10.80, P < 0.001) for MDR, and 9.64 (95% CI 2.71–34.28, P < 0.001) for XDR. Conclusion: Antimicrobial resistance is significantly associated with the risk of major non-infectious morbidity.

KW - Complications

KW - Drug-resistance

KW - Outcome

KW - Pancreas

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=85021785363&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021785363&partnerID=8YFLogxK

U2 - 10.1007/s11605-017-3483-1

DO - 10.1007/s11605-017-3483-1

M3 - Article

AN - SCOPUS:85021785363

VL - 21

SP - 1650

EP - 1657

JO - Journal of Gastrointestinal Surgery

JF - Journal of Gastrointestinal Surgery

SN - 1091-255X

IS - 10

ER -