title: Infectious complications after esophagectomy.
abstract: BACKGROUND
  Esophageal cancer is a serious diagnosis that has a relative incidence of 4/100,000 inhabitants in the Czech Republic. This disorder is managed predominantly by surgery. The steps to improving the outcome of treatment include a multifactorial approach. The role of operative technique in improving outcomes seems to have reached its limits. However, antibiotic prophylaxis and the treatment of complicating bacterial infections continue to play important roles.
  
  
  METHODS
  A total of 85 patients with strictly defined antibiotic prophylaxis during surgical esophagectomy were included in our study. Bacterial strains were isolated from the patient's clinical materials after operation; only one strain from each patient, the first to be isolated, was tested for antibiotic sensitivity.
  
  
  RESULTS
  Infectious complications were observed in 15.3% of patients and the mortality rate from infectious complications reached 30.8%. The most frequently documented complicated infection was pneumonia (69.2%) and the most frequent pathogens were enteric bacteria (56.5%). Some bacterial strains producing extended-spectrum beta-lactamases and AmpC beta-lactamases were found.
  
  
  CONCLUSIONS
  The infections in our patient set were of endogenous origin. In cases of pneumonia, it is appropriate to begin with antibiotics effective against enteric bacteria and Pseudomonas aeruginosa.
authors.affiliation: Department of Surgery I, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Cestmir
authors.initials: C
authors.lastname: Neoral
authors.forename: Martina
authors.initials: M
authors.lastname: Horakova
authors.forename: Rene
authors.initials: R
authors.lastname: Aujesky
authors.forename: Josef
authors.initials: J
authors.lastname: Chudacek
authors.forename: Vojtech
authors.initials: V
authors.lastname: Hanulik
authors.forename: Magdalena
authors.initials: M
authors.lastname: Chroma
authors.forename: Milan
authors.initials: M
authors.lastname: Kolar
mesh_terms: D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis / Q000379:methods; D016470:Bacteremia / Q000382:microbiology* / Q000517:prevention & control; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D006801:Humans; D008172:Lung Diseases, Fungal / Q000382:microbiology* / Q000517:prevention & control; D008480:Mediastinitis / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000382:microbiology* / Q000517:prevention & control; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000382:microbiology* / Q000517:prevention & control