The spectrum of pathogens and their resistance in patients with malignant liver and biliary tract tumors with biliary obstruction after extensive liver resections

Authors

DOI:

https://doi.org/10.14739/2310-1210.2024.5.310543

Keywords:

liver, liver tumors, liver resections, infectious, complications, antibiotic resistance microbial

Abstract

The aim of the study to assess the resistance of infectious complication pathogens to antibacterial drugs in patients after major liver resection (MLR) with or without biliary obstruction.

Material and methods. A total of 105 patients were assigned to 2 groups: group 1 consisted of 53 patients (7 – with hepatocellular carcinoma (HCC), 28 – with cholangiocarcinoma (CC), 18 – with metastases of colorectal cancer) with biliary obstruction; group 2 – 52 patients (25, 10 and 17, respectively) without biliary obstruction.

Results. A microbiological examination of urine, blood, sputum, bile, pharyngeal and wound samples was performed after MLR.

Conclusions. Patients with HCC and CC with biliary obstruction after MLR had infectious complications in 100.0 % of cases, patients without biliary obstruction – in 25.7%; Gram-positive microorganisms were statistically significantly more often isolated from them: Enterococcus faecalis in 17.1 % (р1,2 = 0.01); gram-negative microorganisms: Escherichia coli in 5.7 % (р1,2 = 0.05), hemolytic Escherichia coli in 5.7 % (р1,2 = 0.05), Pseudomonas aeruginosa in 5.7 % (р1,2 = 0.05); fungi in 8.6 % (р1,2 = 0.04); significantly more often, Enterococcus faecalis was isolated from blood in 5.7 % (р1,2 = 0.05), Enterococcus faecium – from urine in 8.6 % (р1,2 = 0.05), Candida albicans – from wounds in 5.7 % (р1,2 = 0.05) and sputum in 8.6 % (р1,2 = 0.02).

Author Biographies

V. P. Romaniuk, Medical Center “Universal Clinic “Oberig”, Kyiv, Ukraine

MD, Postgraduate student of the Department of Internal Diseases, Faculty of Dentistry, Bogomolets National Medical University; General Practitioner, Gastroenterologist, Head of the Infection Control Department

O. H. Kotenko, Medical Center “Universal Clinic “Oberig”, Kyiv, Ukraine

MD, PhD, DSc, Professor, Head of the Department of Liver, Pancreas and Transplantation Surgery

G. A. Solovyova, Bogomolets National Medical University, Kyiv, Ukraine

MD, PhD, DSc, Professor, Acting Head of the Department of Internal Diseases, Faculty of Dentistry

References

Aleksieieva AI. Rol mikrobiolohichnoho monitorynhu u vyznachenni mikrobnoho peizazhu ta poshyrenosti antybiotykorezystentnykh mikroorhanizmiv [The role of microbiological monitoring in determining the microbial landscape and prevalence of antibiotic-resistant microorganisms]. Zdorovia Ukrainy. Onkolohiia. Hematolohiia. Khimioterapiia. 2023;(4):27. Ukrainian. Available from: https://health-ua.com/diagnostics/klinicna-laboratorna-diagnostika/74691-rol-mkrobologchnogo-montoringu-uviznachenn-mkrobnogo-pejzazhu-taposhirenost

Herman P, Fonseca GM, Coelho FF, Kruger JA, Makdissi FF, Jeismann VB, et al. Two decades of liver resection with a multidisciplinary approach in a single institution: What has changed? Analysis of 1409 cases. Clinics (Sao Paulo). 2022;77:100088. doi: https://doi.org/10.1016/j.clinsp.2022.100088

Knitter S, Noltsch AR, Pesthy S, Beierle AS, Krenzien F, Schöning W, et al. Postoperative infectious complications are associated with diminished overall survival of patients undergoing resection for colorectal liver metastases. Eur J Surg Oncol. 2023;49(9):106920. doi: https://doi.org/10.1016/j.ejso.2023.04.019

Lederer AK, Chikhladze S, Kohnert E, Huber R, Müller A. Current Insights: The Impact of Gut Microbiota on Postoperative Complications in Visceral Surgery-A Narrative Review. Diagnostics (Basel). 2021;11(11):2099. doi: https://doi.org/10.3390/diagnostics11112099

Mikami K, Watanabe N, Tochio T, Kimoto K, Akama F, Yamamoto K. Impact of Gut Microbiota on Host Aggression: Potential Applications for Therapeutic Interventions Early in Development. Microorganisms. 2023;11(4):1008. doi: https://doi.org/10.3390/microorganisms11041008

Li B, Qin Y, Qiu Z, Ji J, Jiang X. A cohort study of hepatectomy-related complications and prediction model for postoperative liver failure after major liver resection in 1,441 patients without obstructive jaundice. Ann Transl Med. 2021;9(4):305. doi: https://doi.org/10.21037/atm-20-5472

Mancuso G, Midiri A, Gerace E, Biondo C. Bacterial Antibiotic Resistance: The Most Critical Pathogens. Pathogens. 2021;10(10):1310. doi: https://doi.org/10.3390/pathogens10101310

Pinchera B, Buonomo AR, Schiano Moriello N, Scotto R, Villari R, Gentile I. Update on the Management of Surgical Site Infections. Antibiotics (Basel). 2022;11(11):1608. doi: https://doi.org/10.3390/antibiotics11111608

Jasuja JK, Zimmermann S, Burckhardt I. Evaluation of EUCAST rapid antimicrobial susceptibility testing (RAST) for positive blood cultures in clinical practice using a total lab automation. Eur J Clin Microbiol Infect Dis. 2020;39(7):1305-13. doi: https://doi.org/10.1007/s10096-020-03846-3

Kowalska-Krochmal B, Dudek-Wicher R. The Minimum Inhibitory Concentration of Antibiotics: Methods, Interpretation, Clinical Relevance. Pathogens. 2021;10(2):165. doi: https://doi.org/10.3390/pathogens10020165

Bhat S, Muthunatarajan S, Mulki SS, Archana Bhat K, Kotian KH. Bacterial Infection among Cancer Patients: Analysis of Isolates and Antibiotic Sensitivity Pattern. Int J Microbiol. 2021;2021:8883700. doi: https://doi.org/10.1155/2021/888370

Nanayakkara AK, Boucher HW, Fowler VG Jr, Jezek A, Outterson K, Greenberg DE. Antibiotic resistance in the patient with cancer: Escalating challenges and paths forward. CA Cancer J Clin. 2021;71(6):488-504. doi: https://doi.org/10.3322/caac.21697

Farsi S, Salama I, Escalante-Alderete E, Cervantes J. Multidrug-Resistant Enterococcal Infection in Surgical Patients, What Surgeons Need to Know. Microorganisms. 2023;11(2):238. doi: https://doi.org/10.3390/microorganisms11020238

Leekha S, Terrell CL, Edson RS. General principles of antimicrobial therapy. Mayo Clin Proc. 2011;86(2):156-67. doi: https://doi.org/10.4065/mcp.2010.0639

Bednarsch J, Czigany Z, Heij LR, Luedde T, van Dam R, Lang SA, et al. Bacterial bile duct colonization in perihilar cholangiocarcinoma and its clinical significance. Sci Rep. 2021;11(1):2926. doi: https://doi.org/10.1038/s41598-021-82378-y

Călina D, Docea AO, Rosu L, Zlatian O, Rosu AF, Anghelina F, et al. Antimicrobial resistance development following surgical site infections. Mol Med Rep. 2017;15(2):681-8. doi: https://doi.org/10.3892/mmr.2016.6034

Daca A, Jarzembowski T. From the Friend to the Foe-Enterococcus faecalis Diverse Impact on the Human Immune System. Int J Mol Sci. 2024;25(4):2422. doi: https://doi.org/10.3390/ijms25042422

Miuțescu B, Vuletici D, Burciu C, Turcu-Stiolica A, Bende F, Rațiu I, et al. Identification of Microbial Species and Analysis of Antimicrobial Resistance Patterns in Acute Cholangitis Patients with Malignant and Benign Biliary Obstructions: A Comparative Study. Medicina (Kaunas). 2023;59(4):721. doi: https://doi.org/10.3390/medicina59040721

Boesch M, Horvath L, Baty F, Pircher A, Wolf D, Spahn S, et al. Compartmentalization of the host microbiome: how tumor microbiota shapes checkpoint immunotherapy outcome and offers therapeutic prospects. J Immunother Cancer. 2022;10(11):e005401. doi: https://doi.org/10.1136/jitc-2022-005401

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Published

2024-10-04

How to Cite

1.
Romaniuk VP, Kotenko OH, Solovyova GA. The spectrum of pathogens and their resistance in patients with malignant liver and biliary tract tumors with biliary obstruction after extensive liver resections. Zaporozhye Medical Journal [Internet]. 2024Oct.4 [cited 2024Nov.22];26(5):397-402. Available from: http://zmj.zsmu.edu.ua/article/view/310543

Issue

Vol. 26 No. 5 (2024): Zaporozhye medical journal

Section

Original research

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