TO STUDY THE CLINICO-MICROBIOLOGICAL PROFILE OF AN INTRA-ABDOMINAL INFECTIONS IN THE SURGICAL INTENSIVE CARE UNIT
DOI:
https://doi.org/10.22159/ajpcr.2024v17i11.52085Keywords:
Intra-abdominal infections,, Surgical ICU, antimicrobial susceptibility testingAbstract
Objective: Intra-abdominal infections (IAIs) pose a severe challenge in surgical intensive care units (ICUs). These infections, which can develop from conditions such as peritonitis, appendicitis, and intra-abdominal abscesses, often worsen into severe complications such as sepsis and multi- organ failure. Early and accurate diagnosis, along with rapid and effective treatment, is crucial for improving the survival and recovery of patients in the surgical ICU who are affected by these life-threatening infections. This study focuses on the clinical and microbiological profile of IAIs in the surgical ICU, emphasizing the importance of understanding the microbial landscape.
Methods: This prospective study was carried out in the Department of Microbiology over the course of 1 year. Patients with suspected IAIs admitted to the surgical ICU were included in the study. The samples were received and processed as per standard protocols. Identification and antimicrobial susceptibility testing were done by the Vitek-2 system, and isolates were characterized as multi-/extensively/pan-drug resistant.
Results: Out of 1010 patients admitted to the surgical ICU, infections were present in 81 patients (53 males and 28 females), resulting in an infection rate of 8%. The most common comorbidity was diabetes mellitus (28.3%), and the most common risk factors were sepsis (19.7%), alcohol intake (18.5%), and immobilization (16%). A total of 87 isolates were obtained. The most common isolate was Escherichia coli (47.1%), followed by Klebsiella pneumoniae (26.4%). E. coli showed maximum sensitivity for amikacin (76.7%), followed by tigecycline (74.4%). 81.6% of isolates were multidrug-resistant, and 62.7% were extensively drug-resistant.
Conclusion: Knowledge of antimicrobial resistance patterns provides guidance for the treatment, thus improving outcomes.
Downloads
References
Blot S, Antonelli M, Arvaniti K, Blot K, Creagh-Brown B, de Lange D et al. Epidemiology of intra-abdominal infection and sepsis in critically ill patients: ”AbSeS”, a multinational observational cohort study and ESICM Trials Group Project. Intensive Care Med. 2019;45(12):1703- 17. doi: 10.1007/s00134-019-05819-3, PMID 31664501.
Sartelli M, Barie P, Agnoletti V, Al-Hasan MN, Ansaloni L, Biffl W et al. Intra-abdominal infections survival guide: a position statement by the Global Alliance for Infections in Surgery. World J Emerg Surg. 2024;19(1):22. doi: 10.1186/s13017-024-00552-9, PMID 38851700.
Marshall JC. Intra-abdominal infections. Microbes Infect. 2004;6(11):1015-25. doi: 10.1016/j.micinf.2004.05.017, PMID 15345234.
Admas D, Demeke G, Adugna A, Esmael A. Bacterial etiologies, antimicrobial susceptibility pattern and associated factors among patients suspected sterile body site infections at DebreMarkos Comprehensive Specialized Hospital, Northwest, Ethiopia. Front Med (Lausanne). 2024;11(5):1260841.
Gelot S, Nakhla E. Intra-abdominal infections in adults. US Pharm. 2016;41(4):HS5-HS12.
Silva-Nunes J, Cardoso T. Intra-abdominal infections: the role of different classifications on the selection of the best antibiotic treatment. BMC Infect Dis. 2019;19(1):980. doi: 10.1186/s12879-019-4604-0, PMID 31752716.
Tsegay E, Hailesilassie A, Hailekiros H, Niguse S, Saravanan M, Abdulkader M. Bacterial isolates and drug susceptibility pattern of sterile body fluids from tertiary hospital, Northern Ethiopia: A four-year retrospective study. J Pathog. 2019;2019:5456067. doi: 10.1155/2019/5456067, PMID 31263599.
Mackey & McCartney practical medical microbiology. 14th ed. Edinburgh: Churchill Livingstone; 1996.
Alkofide H, Alhammad AM, Alruwaili A, Aldemerdash A, Almangour TA, Alsuwayegh A, et al. Multidrug-resistant and extensively drug-resistant Enterobacteriaceae: prevalence, treatments, and outcomes - A retrospective cohort study. Infect Drug Resist. 2020;13:4653-62. doi: 10.2147/IDR.S283488, PMID 33380815.
CLSI. Performance standards for antimicrobial susceptibility testing. 32nd ed. CLSI supplement M100. Clinical and Laboratory Standards Institute; 2022.
Chaithanya J, Ashwini RK, Rajagopalan S. Clinical and microbiological profile in intra-abdominal infection. Int Surg J. 2019;6(10):3608-13.
Bourbeau P, Riley J, Heiter BJ, Master R, Young C, Pierson C. Use of the BacT/Alert blood culture system for culture of sterile body fluids other than blood. J Clin Microbiol. 1998;36(11):3273-7. doi: 10.1128/ JCM.36.11.3273-3277.1998, PMID 9774578.
Ouyang W, Xue H, Chen Y, Gao W, Li X, Wei J et al. Clinical characteristics and antimicrobial patterns in complicated intra-abdominal infections: a 6-year epidemiological study in southern China. Int J Antimicrob Agents. 2016;47(3):210-6. doi: 10.1016/j. ijantimicag.2015.12.019, PMID 26899413.
Shree N, Arora BS, Mohil RS, Kasana D, Biswal I. Bacterial profile and patterns of antimicrobial drug resistance in intra-abdominal infections: current experience in a teaching hospital. Indian J Pathol Microbiol. 2013 Oct-Dec;56(4):388-92. doi: 10.4103/0377-4929.125321, PMID 24441227.
Montravers P, Lepape A, Dubreuil L, Gauzit R, Pean Y, Benchimol D et al. Clinical and microbiological profiles of community-acquired and nosocomial intra-abdominal infections: results of the French prospective, observational EBIIA study. J Antimicrob Chemother.2009;63(4):785-94. doi: 10.1093/jac/dkp005, PMID 19196742.
Lugito NP, Cucunawangsih C, Kurniawan A, Tjiang MM. Clinical characteristics and microbiological profiles of community-acquired intra-abdominal infections. Indones J Gastroenterol Hepatol. Dig Endosc. 2014;15(1):4-20.
Ebrahim S, Abera A, Terfe K, Tsiga E, Ayenew Z, Addis T et al. Bacterial profile and antimicrobial susceptibility pattern of isolates recovered from sterile body fluids referred to the National Reference Laboratory. J Public Health Nutr. 2020;4:32-6.
Krobot K, Yin D, Zhang Q, Sen S, Altendorf-Hofmann A, Scheele J et al. Effect of inappropriate initial empiric antibiotic therapy on outcome of patients with community-acquired intra-abdominal infections requiring surgery. Eur J Clin Microbiol Infect Dis. 2004 Sep;23(9):682- 7. doi: 10.1007/s10096-004-1199-0, PMID 15322931.
Sartelli M, Catena F, Ansaloni L, Coccolini F, Corbella D, Moore EE et al. Complicated intra-abdominal infections worldwide: the definitive data of the CIAOW Study. World J Emerg Surg. 2014;9(5):37. doi: 10.1186/1749-7922-9-37, PMID 24883079.
Published
How to Cite
Issue
Section
Copyright (c) 2024 Amarpreet Kaur, Veenu Gupta, PL Gautam
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
