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Relevance: Enterobacteriaceae family microorganisms, specifically E. coli and K. pneumoniae isolates, are the most common activators of postoperative peritonitis in oncology. Many of these microorganisms produce extended-spectrum beta-lactamases (ESBL). The deemed resistance of ESBL-producing enterobacteria to all β-lactam antibiotics, except for carbapenems, leads to the ineffectiveness of empiric antibiotic therapy.&#x0D;The purpose of the study was to define the risk factors of peritoneal contamination with ESBL-producing enterobacteria&#x0D;for choosing optimal empirical antibacterial therapy on the example of a specific cancer patient with postoperative peritonitis.&#x0D;Results: Independent risk factors of peritoneal contamination with ESBL-producing enterobacteria included “the administration of antibiotics for more than three days” (OR 106, 95% CI 21.0-537, p&lt;0.001), “two or more repeated laparotomies” (OR 2.66, 95% CI 1.32-5.34, p=0.006), and “postoperative preventive antibiotic treatment” (OR 0.17, 95% CI 0.04-0.75, p=0.02). The obtained prognostic model allowed predicting the infection with ESBL-producing enterobacteria before establishing the postoperative peritonitis microbial etiology. The model sensitivity was 94.7%, overall predictive accuracy was 73.1. Conclusion: Prolonged administration of antibiotics (3rd-generation cephalosporins and/or fluoroquinolones) after cancer surgery to prevent surgical infections is the main independent risk factor of peritoneal contamination with ESBL- producing enterobacteria.

onkologiâ i radiologiâ kazahstana

Predicting peritoneal contamination with enterobacteria producing extended-spectrum beta-lactamases and choosing empirical antibacterial therapy for postoperative peritonitis in cancer patients