Bacterial profile and patterns of antimicrobial drug resistance in intra-abdominal infections: current experience in a teaching hospital.

June 9, 2015 at 3:24 pm

Indian J Pathol Microbiol. 2013 Oct-Dec;56(4):388-92.

Shree N, Arora BS1, Mohil RS, Kasana D, Biswal I.

1Department of Microbiology, Vardhman Mahavir Medical College & Safdarjang Hospital, New Delhi, India.

Abstract

CONTEXT:

Bacterial isolates from intra-abdominal infections, in particular, peritonitis and their unpredictable antimicrobial resistance patterns, continue to be a matter of concern not only globally but regionally too.

AIM:

An attempt in the present study was made to study the patterns of drug resistance in bacterial isolates, especially gram negative bacilli in intra-abdominal infections (IAI) in our hospital.

MATERIALS AND METHODS:

From 100 cases of peritonitis, identification of isolates was done as per recommended methods. Antimicrobial susceptibility and extended-spectrum beta-lactamase (ESBL) testing were performed following the CLSI guidelines.

RESULTS:

A total of 133 clinical isolates were obtained, of which 108 were aerobes and 22 anaerobes. Fungal isolates were recovered in only three cases. Escherichia coli (47/108) emerged as the most predominant pathogen followed by Klebsiella spp. (27/108), while Bacteroides fragilis emerged as the predominant anaerobe (12/22). Among coliforms, 61.7% E. coli and 74.1% Klebsiella spp. were ESBL positive. A high level of resistance was observed for beta lactams, ciprofloxacin, amikacin, and ertapenem. Ertapenem resistance (30-41%) seen in coliforms, appears as an important issue. Imipenem, tigecycline, and colistin were the most consistently active agents tested against ESBL producers.

CONCLUSION:

Drug resistance continues to be a major concern in isolates from intra-abdominal infections. Treatment with appropriate antibiotics preceded by antimicrobial resistance testing aided by early diagnosis, adequate surgical management, and knowledge of antibiotic – resistant organisms appears effective in reducing morbidity and mortality in IAI cases.

FULL TEXT

http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2013;volume=56;issue=4;spage=388;epage=392;aulast=Shree

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Infecciones intraabdominales, Metodos diagnosticos, Resistencia bacteriana, Sepsis. Tags: .

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