Extended Spectrum-β-Lactamase or Carbapenemase Producing Bacteria Isolated from Patients with Acute Cholangitis

Goo, Ja Chung; Seong, Mun Hyuk; Shim, Young Kwang; Lee, Jun Young; Han, Joung-Ho; Shin, Kyeong Seob; Choi, Jee Woong; Youn, Sei Jin; Park, Seon Mee

doi:10.5946/ce.2012.45.2.155

Cited by 21 publications

(43 citation statements)

References 20 publications

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“…Anaerobes were detected in less than 10% of our patients. These results are consistent with other recent reports [7][8][9][10] and revise the classic view that both enterobacterales and anaerobes are the most important pathogens in biliary tract infections [11]. Bacteremia was detected in one third of cases with available blood culture results.…”

Section: Discussionsupporting

confidence: 92%

Use of microbiological and patient data for choice of empirical antibiotic therapy in acute cholangitis

et al. 2020

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Background: Ineffective antibiotic therapy increases mortality of acute cholangitis. The choice of antibiotics should reflect local resistance patterns and avoid the overuse of broad-spectrum agents. In this study, we analysed how results of bile and blood cultures and patient data can be used for selection of empirical antibiotic therapy in acute cholangits. Methods: Pathogen frequencies and susceptibility rates were determined in 423 positive bile duct cultures and 197 corresponding blood cultures obtained from 348 consecutive patients with acute cholangitis. Patient data were retrieved from the medical records. Associations of patient and microbiological data were assessed using the Chi-2 test and multivariate binary logistic regression. Results: In bile cultures, enterobacterales and enterococci were isolated with equal frequencies of approximately 30% whereas in blood cultures, enterobacterales predominated (56% compared to 21% enterococci). Antibiotic resistance rates of enterobacterales were > 20% for fluorochinolones, cephalosporines and acylureidopenicillins but not for carbapenems (< 2%). The efficacy of empirical therapy was poor with a coverage of bacterial bile and blood culture isolates in 51 and 69%, respectively. By multivariate analysis, predictors for pathogen species, antibiotic susceptibility and expected antibiotic coverage were identified. Conclusions: In unselected patients treated for acute cholangitis in a large tertiary refferential center, use of carbapenems seems necessary to achieve a high antibiotic coverage. However, by analysis of patient and microbiological data, subgroups for highly effective carbapenem-sparing therapy can be defined. For patients with community-acquired cholangitis without biliary prosthesis who do not need intensive care, piperacillin/tazobactam represents a regimen with an expected excellent antibiotic coverage.

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Section: Discussionsupporting

confidence: 92%

Use of microbiological and patient data for choice of empirical antibiotic therapy in acute cholangitis

et al. 2020

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“…However, the pattern of bacterial causes of cIAI infections varies across the Asia–Pacific region. Table 1 shows the most common pathogens causing IAIs in selected Asian countries, alongside data from the USA and Europe [7,9–18] .…”

Section: Clinical Epidemiology Of Ciais In Asiamentioning

confidence: 99%

Antibiotic management of complicated intra-abdominal infections in adults: The Asian perspective

Kurup

Liau

Ren

et al. 2014

Annals of Medicine &Amp; Surgery

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Regional epidemiological data and resistance profiles are essential for selecting appropriate antibiotic therapy for intra-abdominal infections (IAIs). However, such information may not be readily available in many areas of Asia and current international guidelines on antibiotic therapy for IAIs are for Western countries, with the most recent guidance for the Asian region dating from 2007. Therefore, the Asian Consensus Taskforce on Complicated Intra-Abdominal Infections (ACT-cIAI) was convened to develop updated recommendations for antibiotic management of complicated IAIs (cIAIs) in Asia. This review article is based on a thorough literature review of Asian and international publications related to clinical management, epidemiology, microbiology, and bacterial resistance patterns in cIAIs, combined with the expert consensus of the Taskforce members. The microbiological profiles of IAIs in the Asian region are outlined and compared with Western data, and the latest available data on antimicrobial resistance in key pathogens causing IAIs in Asia is presented. From this information, antimicrobial therapies suitable for treating cIAIs in patients in Asian settings are proposed in the hope that guidance relevant to Asian practices will prove beneficial to local physicians managing IAIs.

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“…There are few reports about the prevalence of carbapenem resistant bacteria specifically among patients with acute cholangitis and cholecystitis. One from Korea reported 13 out of 376 (3.5%) isolates in bile were carbapenemase producing .…”

Section: Introductionmentioning

confidence: 99%

Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis

Gomi

Solomkin

Schlossberg

et al. 2018

J Hepato Biliary Pancreat

298

249

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Antimicrobial therapy is a mainstay of the management for patients with acute cholangitis and/or cholecystitis. The Tokyo Guidelines 2018 (TG18) provides recommendations for the appropriate use of antimicrobials for community-acquired and healthcare-associated infections. The listed agents are for empirical therapy provided before the infecting isolates are identified. Antimicrobial agents are listed by classdefinitions and TG18 severity grade I, II, and III subcategorized by clinical settings. In the era of emerging and increasing antimicrobial resistance, monitoring and updating local antibiograms is underscored. Prudent antimicrobial usage and early de-escalation or termination of antimicrobial therapy are now important parts of decision-making. What is new in TG18 is that the duration of antimicrobial therapy for both acute cholangitis and cholecystitis is systematically reviewed. Prophylactic antimicrobial usage for elective endoscopic retrograde cholangiopancreatography is no longer recommended and the section was deleted in TG18. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47. Related clinical questions and references are also included.

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Extended Spectrum-β-Lactamase or Carbapenemase Producing Bacteria Isolated from Patients with Acute Cholangitis

Cited by 21 publications

References 20 publications

Use of microbiological and patient data for choice of empirical antibiotic therapy in acute cholangitis

Use of microbiological and patient data for choice of empirical antibiotic therapy in acute cholangitis

Antibiotic management of complicated intra-abdominal infections in adults: The Asian perspective

Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis

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