Retrospective Study
Copyright ©The Author(s) 2019.
World J Gastroenterol. Nov 7, 2019; 25(41): 6238-6247
Published online Nov 7, 2019. doi: 10.3748/wjg.v25.i41.6238
Table 1 Surgical treatment data from 285 patients with pancreatic head resection
All patients, n = 285 (%)With bacteriobilia (BB+), n = 150 (%)Without bacteriobilia (BB-), n = 135 (%)P value
Indications
Malignancyn = 202 (71)n = 114 (56)an = 88 (44)< 0.05
cP1n = 51 (18)n =23 (45)n =28 (55)0.23
Othersn = 32 (11)n =13 (41)n =19 (59)0.15
Biliary drainage
PBD+n =144 (51)n = 120 (83)bn = 24 (17)< 0.01
PBD-n =141 (49)n = 30 (21)bn = 111 (79)
Cholestasis
PC+n = 120 (42)n = 73 (61)cn = 47 (39)0.02
PC-n = 165 (58)n = 77 (47)cn = 88 (53)
Table 2 Pathogen detection depending on horizontal drain (PBD+/PBD-) or presence of cholestasis (PC+/PC-)
Clinical groupNumber of patients, (n)Patients with bacterobilia, n (%)Bacteria quantity, nFungi
PBD-/PC-No stent/no cholestasis9717 (18)240
PBD-/PC+No stent/cholestasis4413 (30)222
PBD+/PC-Stent/no cholestasis6860 (88)1464
PBD+/PC+Stent/cholestase7660 (80)1509
All groups285150 (53)342
Table 3 Bacterial profile in patients with bacteriobilia, (n = 150)
Patients with…PBD-, n (%)
PBD+, n (%)
P value
30 (20)120 (80)
Polymicrobial mixed flora (n = 104)12 (40)d92 (78)< 0.01
Enterococci (n = 82)9 (30)e73 (61)< 0.05
Streptococci (n = 41)6 (20)35 (29)0.32
Klebsiella (n = 38)6 (20)32 (27)0.45
Escherichia (n = 35)8 (27)27 (23)0.60
Enterobacter (n = 21)1 (3)20 (17)0.06
Multi-drug resistant bacteria (n = 4)1 (3)3 (3)0.80
Table 4 Frequency of sensitivity and resistance compared to standard antibiotic prophylaxis with ampicillin-sulbactam in 342 bacteria
Ampicillin SulbactamImipenemPiperacillin TazobactamCiprofloxacinMoxifloxacinCeftriaxonCefuroxim
PBD+ (n = 296)Sensitivity174 (59)249 (84)e219 (74)e129 (44)e173 (58)147 (50)f126 (43)e
Resistance81 (27)31 (11)e45 (15)e96 (32)49 (17)e62 (21)f115 (39)e
PBD- (n = 46)Sensitivity31 (67)37 (80)33 (72)18 (39) +27 (59)23 (50)f24 (52)
Resistance8 (17)7 (15)8 (17)15 (33)8 (17)13 (28)18 (39)f
Table 5 Antimicrobial efficacy of ampicillin-sulbactam and piperacillin-tazobactam in direct comparison with 342 bacteria
Sensitivity (%)
Signifi-cance
Resistance (%)
Significance
ASPTPASPTP value
TOP5(n = 256)Enterococci (n = 97)7170NS2729NS
Streptococci (n = 58)60g88< 0.0100NS
Klebsiella (n = 43)8698NS14h00.03
Escherichia (n = 36)81g100< 0.0119i00.02
Enterobacter (n = 22)5g91< 0.0195g0< 0.01
Varia(n = 86)Other genera40g80< 0.0134g12< 0.01