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 language | English |
|---|---|
| Pages (from-to) | 1650-1657 |
| Number of pages | 8 |
| Journal | Journal of Gastrointestinal Surgery |
| Volume | 21 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - Oct 1 2017 |
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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 journal › Article
}
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 -