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Master Thesis

Prévalence de la résistance à la témocilline au sein des angiocholites infectieuses bactériémiantes documentées à entérobactéries : expérience de l’hôpital Beaujon

Abstract : Introduction: acute cholangitis is a potentially severe infection due to enterobacteriaceae. Due to the current epidemic of multidrug resistant enterobacteriaceae therapeutic alternatives are needed. Temocillin is a narrow spectrum penicillin which intensively concentrate in the biliary tract and is not inactivated by extended spectrum ß-lactamases and some carabapenemases. Our study tried to evaluate the potential for temocillin as a treatment of bacteriemic acute cholangitis. Methods: we conducted a retrospective study of all bacteriemic acute cholangitis episodes with microbiological documentation of at least one enterobacteriaceae treated at Beaujon Teaching Hospital over a period of 2 years. Results: we analysed 140 acute cholangitis episodes and studied 196 enterobacteriaceae strains including 16 (8%) temocillin resistant strains, mainly isolated in the context of health-associated infections (n=15). Acute cholangitis episodes were classified according susceptibility for all documented bacteria as temocillin effective (103 cases; 74%) or temocillin non-effective (37 cases; 26%). This result was similar to that of first line antibiotics. Univariate analysis showed that a malignant cause for obstruction and severe episodes were associated with predicted temocillin inefficiency. Using temocillin could have spared use of piperacillin/tazobactam or carbapenems in 17 cases (45%). Conclusion: empirical use of temocillin seems limited. However, it could be used for second line treatment after documentation in order to spare piperacillin/tazobactam and carbapenems. Temocillin usage might take up more space in the future due to increasing resistance to antibiotics.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03434411
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Submitted on : Thursday, November 18, 2021 - 11:47:50 AM
Last modification on : Thursday, April 21, 2022 - 5:19:42 PM
Long-term archiving on: : Saturday, February 19, 2022 - 6:51:15 PM

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Sylvain Chawki. Prévalence de la résistance à la témocilline au sein des angiocholites infectieuses bactériémiantes documentées à entérobactéries : expérience de l’hôpital Beaujon. Médecine humaine et pathologie. 2019. ⟨dumas-03434411⟩

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