A DESCRIPTIVE STUDY ON THE TRENDS OF CAUSATIVE BACTERIA AND ANTIMICROBIAL RESISTANCE PROFILES IN PATIENTS WHO DEVELOPED SEPSIS FOLLOWING GASTRIC SLEEVE RESECTION.

BACKGROUND AND AIM: Bacterial sepsis is a significant complication following open gastric sleeve surgery in morbidly obese patients with type 2 diabetes mellitus (T2DM). This study describes the trends in causative bacteria and antimicrobial resistance (AMR) profiles in patients who developed sepsis post-surgery, with inflammatory and glycemic biomarkers as supplementary data to elucidate sepsis pathophysiology.

METHODS

The study included 128 patients (aged 25-40, BMI ≥ 40 kg/m², T2DM) undergoing open gastric sleeve surgery and 40 individuals who underwent open gastric sleeve surgery but did not develop sepsis. Biomarkers (fasting glucose, HbA1c, procalcitonin [PCT], interleukin-6 [IL-6], tumor necrosis factor-alpha [TNF-α]) were measured using Roche Cobas c111 and e411 analyzers. Bacterial pathogens were identified via VITEK 2, and antibiotic susceptibility was tested using the Kirby-Bauer method. Statistical analyses used t-tests and chi-square tests (p<0.05).

RESULTS

Sepsis cases (n=40) showed significantly elevated biomarkers compared to controls (n=40): fasting glucose (143.28±37.79 vs. 82.85±8.12 mg/dL), PCT (7.60±3.07 vs. 0.055±0.031 ng/mL), TNF-α (17.23±5.04 vs. 6.62±2.10 pg/mL), IL-6 (12.47±4.63 vs. 3.06±1.35 pg/mL), and HbA1c (9.37±2.14% vs. 4.22±1.14%) (all p<0.001). Escherichia coli (70%) predominated, with high resistance to amoxicillin/clavulanate (78.57%), ciprofloxacin (67.86%), and gentamicin (60.71%); carbapenems showed minimal resistance. Multidrug-resistant (60.71%) and extensively drug-resistant (21.43%) isolates were prevalent.

CONCLUSION

Escherichia coli dominates postoperative sepsis in this population, with significant AMR complicating treatment. These findings emphasize antibiotic management and tailored prophylaxis. Preoperative optimization efforts are supported by elevated biomarkers showing the role of inflammation and glucose imbalance in sepsis formation.