PMID- 29415186
OWN - NLM
STAT- MEDLINE
DCOM- 20181026
LR  - 20220321
IS  - 1876-4479 (Electronic)
IS  - 1873-9946 (Linking)
VI  - 12
IP  - 6
DP  - 2018 May 25
TI  - Microbial Spectrum of Intra-Abdominal Abscesses in Perforating Crohn's Disease: 
      Results from a Prospective German Registry.
PG  - 695-701
LID - 10.1093/ecco-jcc/jjy017 [doi]
AB  - 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.
FAU - Reuken, P A
AU  - Reuken PA
AD  - Department of Internal Medicine IV [Gastroenterology, Hepatology, and Infectious 
      Diseases], Jena University Hospital, Jena, Germany.
FAU - Kruis, W
AU  - Kruis W
AD  - Klinik fur Gastroenterologie, Pulmonologie und Allgemeine Innere Medizin, 
      Evangelisches Krankenhaus Koln Kalk, University of Cologne, Cologne, Germany.
FAU - Maaser, C
AU  - Maaser C
AD  - Ambulanzzentrum Gastroenterologie, University Teaching Hospital Luneburg, 
      Luneburg, Germany.
FAU - Teich, N
AU  - Teich N
AD  - Internistische Gemeinschaftspraxis fur Verdauungs- und Stoffwechselkrankheiten 
      Leipzig und Schkeuditz, Leipzig, Germany.
AD  - Medical Faculty, Friedrich-Schiller University, Jena, Germany.
FAU - Buning, J
AU  - Buning J
AD  - Department of Internal Medicine I [Gastroenterology], University Hospital 
      Schleswig-Holstein, Campus Lubeck, Lubeck, Germany.
FAU - Preiss, J C
AU  - Preiss JC
AD  - Department of Medicine I [Gastroenterology, Infectious Diseases, Rheumatology], 
      Charite-Universitatsmedizin Berlin, Berlin, Germany.
FAU - Schmelz, R
AU  - Schmelz R
AD  - Department of Internal Medicine 1, University Hospital Carl Gustav Carus, 
      Dresden, Germany.
FAU - Bruns, T
AU  - Bruns T
AD  - Department of Internal Medicine IV [Gastroenterology, Hepatology, and Infectious 
      Diseases], Jena University Hospital, Jena, Germany.
FAU - Fichtner-Feigl, S
AU  - Fichtner-Feigl S
AD  - Department of Surgery, University Medical Center Regensburg, Regensburg, Germany.
FAU - Stallmach, A
AU  - Stallmach A
AD  - Department of Internal Medicine IV [Gastroenterology, Hepatology, and Infectious 
      Diseases], Jena University Hospital, Jena, Germany.
CN  - German IBD Study group [GISG]
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - England
TA  - J Crohns Colitis
JT  - Journal of Crohn's & colitis
JID - 101318676
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Antifungal Agents)
RN  - 0 (Carbapenems)
RN  - 0 (Cephalosporins)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Penicillins)
RN  - 0 (Quinolones)
RN  - 0 (beta-Lactamase Inhibitors)
RN  - 6GNT3Y5LMF (Levofloxacin)
SB  - IM
MH  - Abdominal Abscess/*drug therapy/*microbiology
MH  - Adult
MH  - Anti-Bacterial Agents/pharmacology/*therapeutic use
MH  - Antifungal Agents/therapeutic use
MH  - Candida albicans/isolation & purification
MH  - Carbapenems/therapeutic use
MH  - Cephalosporins/therapeutic use
MH  - Crohn Disease/*complications/drug therapy
MH  - Drug Resistance, Multiple, Bacterial
MH  - Enterobacteriaceae/drug effects/*isolation & purification
MH  - Enterococcus/drug effects/isolation & purification
MH  - Female
MH  - Germany
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Intestinal Perforation/*complications
MH  - Length of Stay
MH  - Levofloxacin/therapeutic use
MH  - Male
MH  - Penicillins/therapeutic use
MH  - Prospective Studies
MH  - Quinolones/therapeutic use
MH  - Registries
MH  - Streptococcus/drug effects/isolation & purification
MH  - Young Adult
MH  - beta-Lactamase Inhibitors/therapeutic use
EDAT- 2018/02/08 06:00
MHDA- 2018/10/27 06:00
CRDT- 2018/02/08 06:00
PHST- 2017/11/13 00:00 [received]
PHST- 2018/02/02 00:00 [accepted]
PHST- 2018/02/08 06:00 [pubmed]
PHST- 2018/10/27 06:00 [medline]
PHST- 2018/02/08 06:00 [entrez]
AID - 4838882 [pii]
AID - 10.1093/ecco-jcc/jjy017 [doi]
PST - ppublish
SO  - J Crohns Colitis. 2018 May 25;12(6):695-701. doi: 10.1093/ecco-jcc/jjy017.