{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:45:32Z","timestamp":1777934732387,"version":"3.51.4"},"reference-count":38,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Surgical Infections"],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Anastomotic leaks after esophagectomy cause significant morbidity and mortality. In addition to their early detection and prompt endoscopic or surgical management, providing adequate antimicrobial agents is a fundamental aspect of therapy. In this study, different types of microbiological samples were analyzed to provide insight into the microbial pathogen spectrum of anastomotic leaks after esophagectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively reviewed patients who developed anastomotic leak after Ivor\u2013Lewis esophagectomy at a German high-volume center between 2016 and 2018. Results of microbiological cultures from surgical samples, chest tube fluid, endoscopic aspirates, and blood cultures were analyzed to determine species and antimicrobial susceptibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Out of 513 consecutive patients undergoing esophagectomy, 74 developed an anastomotic leak. About 88%\u2013100% of positive samples showed growth of gram-positive bacteria, mainly viridians streptococci but also enterococci. Gram-negative bacteria were found in 48%\u201382% of positive samples, mainly enterobacterales. Yeasts were found in 43%\u201364%. The prevalance of multidrug-resistant bacteria was low in our patient population. Expected failure of empiric antibiotic treatment was &lt;10% for piperacillin-tazobactam, meropenem, and tigecycline (each combined with an echinocandin) but not for ampicillin-sulbactam, ceftriaxone plus metronidazole, moxifloxacin, or gentamicine plus clindamycin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>There is a broad microbial pathogen spectrum in anastomotic leaks after esophagectomy. Implications for empiric antimicrobial treatment arise from enterobacterales, enterococci, and yeasts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/sur.2024.300","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T05:16:01Z","timestamp":1741583761000},"page":"371-377","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Microbial Pathogen Spectrum in Anastomotic Leaks after Ivor\u2013Lewis Esophagectomy"],"prefix":"10.1177","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1623-7988","authenticated-orcid":false,"given":"Andreas","family":"Schneider","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Kliniken Maria Hilf, M\u00f6nchengladbach, Germany."},{"name":"Faculty of Medicine and University Hospital of Cologne, Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Cologne, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung-Hun","family":"Chon","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital of Cologne, Department of General, Visceral, Tumor and Transplantation Surgery, University of Cologne, Cologne, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Kasper","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital of Cologne, Department of Gastroenterology and Hepatology, University of Cologne, Cologne, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang A.","family":"Wetsch","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital of Cologne, Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Cologne, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christiane J.","family":"Bruns","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital of Cologne, Department of General, Visceral, Tumor and Transplantation Surgery, University of Cologne, Cologne, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Hohn","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Kliniken Maria Hilf, M\u00f6nchengladbach, Germany."},{"name":"Faculty of Medicine and University Hospital of Cologne, Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Cologne, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004550"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002611"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003500"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003538"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-021-06250-w"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs5.64"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-021-10144-5"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2021.03.003"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2020.106184"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005337"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2016.261"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1086\/649554"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1159\/000375300"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12317"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(16)30086-3"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2017.08.061"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-13-0855"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00009-19"},{"key":"e_1_3_6_20_2","volume-title":"MiQ 03a: Blutkulturdiagnostik: Sepsis, Endokarditis, Katheterinfektionen. 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