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Title: Prevalence of and risk factors for biliary carriage of bacteria showing worrisome and unexpected resistance traits.
Authors: Maseda, E.
Maggi, G.
Gomez-Gil, R.
Ruiz, G.
Madero, R.
Garcia-Perea, A.
Aguilar, L.
Gilsanz, F.
Rodriguez-Baño, J.
metadata.dc.contributor.authoraffiliation: [Maseda,E; Maggi,G; Gilsanz,F] Anesthesiology and Surgical Critical Care Department, Hospital La Paz, Madrid, Spain. [Gomez-Gil,R; Ruiz,G; Garcia-Perea,A] Microbiology Department, Hospital La Paz, Madrid, Spain University Complutense, Madrid, Spain. [Madero,R] Research Department–Biostatistic Unit, Hospital La Paz, Madrid, Spain. [Aguilar,L] Microbiology Department, School of Medicine, University Complutense, Madrid, Spain. [Rodriguez-Baño,J] Infectious Diseases and Clinical Microbiology Unit, Hospital University Virgen Macarena, Sevilla, Spain.
Keywords: Bilis;Enfermedades de los conductos biliares Laparoscópica;Factores de riesgo;Farmacorresistencia bacteriana;Prevalencia
metadata.dc.subject.mesh: Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents
Medical Subject Headings::Organisms::Bacteria
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections
Medical Subject Headings::Anatomy::Fluids and Secretions::Bodily Secretions::Bile
Medical Subject Headings::Diseases::Digestive System Diseases::Biliary Tract Diseases::Bile Duct Diseases
Medical Subject Headings::Phenomena and Processes::Microbiological Phenomena::Drug Resistance, Microbial::Drug Resistance, Bacterial
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Radiography::Radiography, Abdominal::Cholangiography::Cholangiopancreatography, Endoscopic Retrograde
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged
Medical Subject Headings::Information Science::Information Science::Data Collection::Vital Statistics::Morbidity::Prevalence
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult
Issue Date: Feb-2013
Publisher: American Society for Microbiology
Citation: Maseda E, Maggi G, Gomez-Gil R, Ruiz G, Madero R, Garcia-Perea A, et al. Prevalence of and risk factors for biliary carriage of bacteria showing worrisome and unexpected resistance traits. J. Clin. Microbiol. 2013; 51(2):518-21
Abstract: Data on biliary carriage of bacteria and, specifically, of bacteria with worrisome and unexpected resistance traits (URB) are lacking. A prospective study (April 2010 to December 2011) was performed that included all patients admitted for <48 h for elective laparoscopic cholecystectomy in a Spanish hospital. Bile samples were cultured and epidemiological/clinical data recorded. Logistic regression models (stepwise) were performed using bactobilia or bactobilia by URB as dependent variables. Models (P < 0.001) showing the highest R(2) values were considered. A total of 198 patients (40.4% males; age, 55.3 ± 17.3 years) were included. Bactobilia was found in 44 of them (22.2%). The presence of bactobilia was associated (R(2) Cox, 0.30) with previous biliary endoscopic retrograde cholangiopancreatography (ERCP) (odds ratio [OR], 8.95; 95% confidence interval [CI], 2.96 to 27.06; P < 0.001), previous admission (OR, 2.82; 95% CI, 1.10 to 7.24; P = 0.031), and age (OR, 1.09 per year; 95% CI, 1.05 to 1.12; P < 0.001). Ten out of the 44 (22.7%) patients with bactobilia carried URB: 1 Escherichia coli isolate (CTX-M), 1 Klebsiella pneumoniae isolate (OXA-48), 3 high-level gentamicin-resistant enterococci, 1 vancomycin-resistant Enterococcus isolate, 3 Enterobacter cloacae strains, and 1 imipenem-resistant Pseudomonas aeruginosa strain. Bactobilia by URB (versus those by non-URB) was only associated (R(2) Cox, 0.19) with previous ERCP (OR, 11.11; 95% CI, 1.98 to 62.47; P = 0.006). For analyses of patients with bactobilia by URB versus the remaining patients, previous ERCP (OR, 35.284; 95% CI, 5.320 to 234.016; P < 0.001), previous intake of antibiotics (OR, 7.200; 95% CI, 0.962 to 53.906; P = 0.050), and age (OR, 1.113 per year of age; 95% CI, 1.028 to 1.206; P = 0.009) were associated with bactobilia by URB (R(2) Cox, 0.19; P < 0.001). Previous antibiotic exposure (in addition to age and previous ERCP) was a risk driver for bactobilia by URB. This may have implications in prophylactic/therapeutic measures.
Description: Journal Article;
metadata.dc.identifier.doi: 10.1128/JCM.02469-12
ISSN: 1098-660X (Online)
0095-1137 (Print)
Appears in Collections:01- Artículos - Hospital Virgen Macarena

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