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 journalArticlepeer-review

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

Keywords

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

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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