Universität zu Köln

Reuken, P. A., Kruis, W., Maaser, C., Teich, N., Buening, J., Preiss, J. C., Schmelz, R., Bruns, T., Fichtner-Feigl, S. and Stallmach, A. (2018). Microbial Spectrum of Intra-Abdominal Abscesses in Perforating Crohn's Disease: Results from a Prospective German Registry. J. Crohns Colitis, 12 (6). S. 695 - 702. OXFORD: OXFORD UNIV PRESS. ISSN 1876-4479

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Abstract

Background: Intra-abdominal abscesses [IAAs] are common life-threatening complications in patients with Crohn's disease [CD]. In addition to interventional drainage and surgical therapy, empirical antibiotic therapy represents a cornerstone of treatment, but contemporary data on microbial spectra and antimicrobial resistance are scarce. Methods: We recruited 105 patients with CD and IAAs from nine German centres for a prospective registry in order to characterize the microbiological spectrum, resistance profiles, antibiotic therapy and outcome. Results: In 92 of 105 patients, microbial investigations of abscess material revealed pathogenic microorganisms. A total of 174 pathogens were isolated, with a median of 2 pathogens per culture [range: 1-6]. Most frequently isolated pathogens were E. coli [45 patients], Streptococcus spp. [28 patients], Enterococci [27 patients], Candida [13 patients] and anaerobes [12 patients]. Resistance to third-generation cephalosporins, penicillins with beta-lactamase inhibitors and quinolones were observed in 51, 36 and 35 patients, respectively. Seven patients had multiple-drug-resistant bacteria. Thirty patients received inadequate empirical treatment, and this was more frequent in patients receiving steroids or immunosuppression [37%] than in patients without immunosuppression [10%: p = 0.001] and was associated with a longer hospital stay [21 days vs 13 days, p = 0.003]. Conclusion: Based on antimicrobial resistance profiles, we herein report a high rate of inadequate empirical first-line therapy for IAAs in CD, especially in patients receiving immunosuppression, and this is associated with prolonged hospitalization.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Reuken, P. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kruis, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Maaser, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Teich, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Buening, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Preiss, J. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmelz, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fichtner-Feigl, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stallmach, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-184964
DOI:	10.1093/ecco-jcc/jjy017
Journal or Publication Title:	J. Crohns Colitis
Volume:	12
Number:	6
Page Range:	S. 695 - 702
Date:	2018
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1876-4479
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SPONTANEOUS BACTERIAL PERITONITIS; INTENSIVE-CARE-UNIT; ANTIBIOTIC-RESISTANCE; PERCUTANEOUS DRAINAGE; SECONDARY PERITONITIS; CONSECUTIVE PATIENTS; PELVIC ABSCESS; SEPTIC SHOCK; RISK-FACTORS; INFECTIONS Multiple languages Gastroenterology & Hepatology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18496