Microbiological etiology and current resistance patterns in acute calculous cholecystitis

[Display omitted] The current treatment for acute calculous cholecystitis (ACC) is early laparoscopic cholecystectomy, in association with appropriate empiric antibiotic therapy. In our country, the evolution of the prevalence of the germs involved and their resistance patterns have been scarcely de...

Full description

Saved in:
Bibliographic Details
Published in:Cirugia española (English ed.) 2024-07, Vol.102 (7), p.373-380
Main Authors: de Miguel-Palacio, Maite, González-Castillo, Ana-María, Martín-Ramos, María, Membrilla-Fernández, Estela, Pelegrina-Manzano, Amalia, Pons-Fragero, María-José, Grande-Posa, Luis, Sancho-Insenser, Juan-José
Format: Article
Language:English
Subjects:
Acute calculous cholecystitis
Adecuación antibiótica
Adult
Aged
Aged, 80 and over
Ancianos
Anti-Bacterial Agents - therapeutic use
Antibioterapia amplio espectro
Antibioterapia empírica
Antibiotic appropriateness
Ascitic Fluid - microbiology
Bacterias multirresistentes
Beta-Lactamasas de espectro extendido
Bile - microbiology
Broad-spectrum antibiotic therapy
Candida - drug effects
Candida - isolation & purification
Cholecystectomy, Laparoscopic
Cholecystitis, Acute - microbiology
Citrobacter - isolation & purification
Colecistitis aguda litiásica
Drug Resistance, Bacterial
Elderly
Empirical antibiotic therapy
Enterobacter - isolation & purification
Enterococcus - drug effects
Enterococcus - isolation & purification
Escherichia coli - isolation & purification
Extended-spectrum beta-lactamases
Female
Humans
Klebsiella - drug effects
Klebsiella - isolation & purification
Male
Microbiology
Microbiología
Middle Aged
Multidrug-resistant bacteria
Retrospective Studies
Streptococcus - isolation & purification
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:[Display omitted] The current treatment for acute calculous cholecystitis (ACC) is early laparoscopic cholecystectomy, in association with appropriate empiric antibiotic therapy. In our country, the evolution of the prevalence of the germs involved and their resistance patterns have been scarcely described. The aim of the study was to analyze the bacterial etiology and the antibiotic resistance patterns in ACC. We conducted a single-center, retrospective, observational study of consecutive patients diagnosed with ACC between 01/2012 and 09/2019. Patients with a concomitant diagnosis of pancreatitis, cholangitis, postoperative cholecystitis, histology of chronic cholecystitis or carcinoma were excluded. Demographic, clinical, therapeutic and microbiological variables were collected, including preoperative blood cultures, bile and peritoneal fluid cultures. A total of 1104 ACC were identified, and samples were taken from 830 patients: bile in 89%, peritoneal fluid and/or blood cultures in 25%. Half of the bile cultures and less than one-third of the blood and/or peritoneum samples were positive. Escherichia coli (36%), Enterococcus spp (25%), Klebsiella spp (21%), Streptococcus spp (17%), Enterobacter spp (14%) and Citrobacter spp (7%) were isolated. Anaerobes were identified in 7% of patients and Candida spp in 1%. Nearly 37% of patients received inadequate empirical antibiotic therapy. Resistance patterns were scrutinized for each bacterial species. The main causes of inappropriateness were extended-spectrum beta-lactamase–producing bacteria (34%) and Enterococcus spp (45%), especially in patients older than 80 years. Updated knowledge of microbiology and resistance patterns in our setting is essential to readjust empirical antibiotic therapy and ACC treatment protocols. El tratamiento actual de la colecistitis aguda litiásica (CAL) es la colecistectomía laparoscópica precoz, asociada a una antibioticoterapia empírica apropiada. La prevalencia de los gérmenes causantes y sus resistencias han sido poco descritas en nuestro medio. El objetivo del estudio fue analizar la etiología bacteriana y sus patrones de resistencia antibiótica en CAL. Estudio observacional unicéntrico, retrospectivo, de pacientes consecutivos diagnosticados de CAL en 01/2012-09/2019. Se excluyeron los pacientes con diagnóstico concomitante de pancreatitis, colangitis, colecistitis postoperatoria, estudio anatomopatológico de colecistitis crónica o carcinoma. Se recogieron variables demo
ISSN:2173-5077
2173-5077
DOI:10.1016/j.cireng.2024.04.003