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Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
08:58

Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes

Published on: March 3, 2023

Risk factors for increased antimicrobial resistance: a retrospective analysis of 309 acute cholangitis episodes

Jochen Schneider1, Pierre De Waha, Alexander Hapfelmeier

  • 1Institute of Medical Microbiology, Immunology and Hygiene, Technische Universität München, München, Germany.

The Journal of Antimicrobial Chemotherapy
|October 3, 2013
PubMed
Abstract

Insights

Stent therapy increases antimicrobial resistance in patients with acute cholangitis. Numerous prior interventional procedures further elevate this risk, impacting treatment effectiveness.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Enterobacteriaceae are common pathogens in biliary tract infections.
  • Antimicrobial resistance (AMR) poses a significant challenge in managing acute cholangitis.
  • Identifying risk factors for AMR is crucial for effective treatment strategies.

Purpose of the Study:

  • To identify risk factors associated with increased antimicrobial resistance in Enterobacteriaceae causing acute cholangitis.
  • To evaluate the impact of interventions and patient characteristics on resistance patterns.

Main Methods:

  • Retrospective analysis of 276 patients with acute cholangitis.
  • Comparison of resistance patterns in Enterobacteriaceae from blood/bile cultures.
  • Analysis of risk factors including age, sex, cholangitis genesis, and interventional procedures (percutaneous transhepatic cholangiography/endoscopic retrograde cholangiography).
  • Utilized univariate and multivariate generalized estimation equation models.

Main Results:

  • Stent therapy was associated with a lower proportion of susceptible Enterobacteriaceae to quinolones and ceftriaxone.
  • Patients undergoing stent therapy had a 4-fold higher odds of acquiring ceftriaxone-resistant Enterobacteriaceae.
  • Each additional interventional procedure (PTC/ERC) decreased susceptibility to multiple antibiotics, including quinolones and ceftriaxone.
  • Age, sex, and type of intervention were not significant risk factors for AMR.

Conclusions:

  • Stent therapy is a significant risk factor for developing antimicrobial resistance in acute cholangitis.
  • A higher number of prior interventional procedures exacerbates the risk of antimicrobial resistance.
  • These findings highlight the need for careful consideration of interventions in patients with biliary infections and emerging resistance.
Keywords:
Enterobacteriaceaebacterial infectionsgastrointestinal tract microbiology

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