Complicated Intraabdominal Infections; Epidemiology of Microorganisms, Resistance Profiles ans Risk Factors Associated with Mortality

Aim: The threat of antimicrobial resistance has been identified as one of the major challenges in the management of complicated intra-abdominal infections(cIAIs). In this study, we aimed to describe the clinical, microbiological and resistance profiles of complicated intra-abdominal infections and to assess the risk factors related to resistance and mortality. Material and Method: Seventy-nine patients undergoing surgery or interventional drainage for cIAIs with a positive microbiological culture were documented. Results: Among these patients 79,7% were affected by health care associated IAIs while remaining 20,3% cases were identified as cIAI in the community. In 79 cases, 143 microorganisms were isolated and the leading microorganism was E.coli (34.9%) followed by Enterococcus spp. (17.4%). Among Enterobacteriaceae (n:96), 53.6% of the strains had ESBL and 36.8% were Multi Drug Resistant (MDR) bacteria. The overall mortality rate was 22.8%. According to univariate analysis, the use of broad spectrum antibiotics between initial intervention and re-operation was a significant risk factor for presence of ESBL. By multivariate analysis of the data; isolation of MDR bacteria, Enterococcus spp as an etiologic agent and presence of chronic obstructive pulmonary disease were statistically significant indicators for mortality. Discussion: These data indicate that local community and nosocomial resistance patterns should guide empiric antimicrobial therapy. Conclusion: To have the efficient data for resistance patterns, culture of the materials should not be neglected in either hospital or community acquired IAIs.Due to the increase in the prevalence of ESBL positive and MDR bacteria, demonstration of the epidemiological data in populations and each hospital is crucially important for accurate selection of initial empirical antibiotherapy