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[Epidemiology and risk factors of patients with intra-abdominal postsurgical infection treated with tigecycline: a cohort study].

[Epidemiology and risk factors of patients with intra-abdominal postsurgical infection treated with tigecycline: a cohort study].
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Torres G, Paredes M, Hernández A, García C, Sánchez Bueno F, Canteras M, Parrilla P, Gómez J,


Torres G, Paredes M, Hernández A, García C, Sánchez Bueno F, Canteras M, Parrilla P, Gómez J, (click to view)

Torres G, Paredes M, Hernández A, García C, Sánchez Bueno F, Canteras M, Parrilla P, Gómez J,

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Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia 2016 12 23() pii torres23dec2016
Abstract
OBJECTIVE
To study a cohort of patients with intra-abdominal postsurgical infection treated with tigecycline to analyze its effectiveness and mortality related factors.

METHODS
Prospective study of patients with intra-abdominal postsurgical infection with microbiological isolation and treated with tigecycline.

RESULTS
Out of 103 patients only 61 full fit inclusion criteria. Mean age was 67 year-old and 72% were male. Charlson score was ≥ 3 in 65.5%, being diabetes and colon cancer the most prevalent diseases. Cancer surgery was the most frequent procedure (n=44, 72%) and previous antibiotic administration was present in 43 cases (69%). Pitt score was ≥ 3 in 69% and most prevalent bacteria were Escherichia coli (38 %), Enterococcus spp. (34%; mainly Enterococcus faecium) and Klebsiella pneumoniae together with Enterobacter cloacae (28%). Tigecycline was prescribed alone (17; 28%) or in combination with other antibiotics (44; 72%), mainly meropenem (25; 57%) or amikacin (19, 43%). 11 patients died (18%), all of which suffered extended cancer surgery and isolation of extended-spectrum betalactamase producing Enterobacteriaceae. Factors statistically associated to death in univariate analysis were Charlson score >3, pH <7.3 and leucocyte count >20.000 cells/mm3.

CONCLUSIONS
As being a cohort of patients treated with tigecycline, E. faecium isolation was very frequent. Non-fatal evolution was achieved in 82% cases, being tigecycline a potentially good option in the empiric treatment of very severe infections.

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