Antimicrobial Resistance Profile in Complicated Intra-abdominal Infections

Abstract

Background: Early administration of appropriate empirical antibiotics is integral part of early management of complicated intra-abdominal infections. Selection of empiric antibiotics relies upon microbiologic profile and resistance patterns of commonly encountered organisms in hospital and community. In developing countries, limited microbiological susceptibility information can result in either under treatment or unnecessarily broad coverage.
Objectives: To find out frequency of various micro-organisms and their resistance profiles to help decide empiric antibiotics to be used in complicated intra-abdominal infections.

Methods: We conducted review of medical records of adult patients admitted from Jan 2012 to Dec 2015 with complicated intraabdominal infections.
Results: Mean age of 317 patients included in the study was 51+/-18 years. Healthcare associated infections were present in 57% of patients. Most common source of infection was large bowel and appendix accounting for 22% of cases, followed by pancreatic infection (20%). Common organisms reported were E. Coli (56%), Enterococci (28%) and Klebsiella Pneumoniae (15%). Extended Spectrum Beta Lactamase (ESBL) producers were 75% of E Coli and 55% of Klebsiella Pneumoniae isolates. Cabapenem resistance was present in 8% of Klebsiella Pneumoniae isolates. 

Conclusion: High prevalence of ESBL producing gram negative rods and resistance to other broad spectrum antibiotics especially in healthcare associated infection needs to be kept in mind while planning empiric antibiotics therapy in complicated intraabdominal.

Key Words: Intra-abdominal Infections, Antibiotics, Microbiology, Bacteria