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01-10-2017 | Original Article

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

Authors: 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

Published in: Journal of Gastrointestinal Surgery | Issue 10/2017

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.

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Title: Consequences of Increases in Antibiotic Resistance Pattern on Outcome of Pancreatic Resection for Cancer
Authors: 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
Publication date: 01-10-2017
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 10/2017
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-017-3483-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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