The Relationship of microbiological examination result profile to the severity of complicated intra-abdominal infection Patients at a tertiary hospital in Indonesia

Background: Complicated intra-abdominal infection (cIAI) is one of the contributors to non-traumatic morbidity and fatality in clinical settings. Risk stratification severity tools such as the World Society of Emergency Surgery Sepsis Severity Score (WSESSSS) and the Calgary Predisposition, Infection, Response, and Organ Dysfunction (CPIRO) score have been developed to predict clinical outcomes. The association between the causative microorganisms of cIAI and disease severity has not yet been explored, especially using clinical data from Indonesia. Objectives: To determine the relationship between the microbiological examination profiles of species identification and antimicrobial resistance to the severity of patients with cIAI assessed by WSESSSS and CPIRO. Methods: This retrospective observational study analyzed data from the electronic medical record of a tertiary hospital in Indonesia. Patients diagnosed with cIAI who underwent microbiological examination of intraoperative specimens in 2024 were included. Data were analyzed statistically. Results: A total of 102 patients met the inclusion criteria. The mean WSESSSS was 7.59 ± 3.0 (median 8.0; IQR 4.0). The mean CPIRO score was 1.65 ± 1.27 (median 1.0; IQR 1.0). Escherichia coli was the most frequently found microorganism (53.59%). ESBL-producing bacteria were found in 49 isolates (32.03%) and carbapenem-resistant bacteria in 11 isolates (7.19%). The WSESSSS were significantly higher in the patient with resistant bacteria group compared to the non-resistant group (p<0.001; r=0.37). Conclusion: A significant relationship was found between the microorganism resistance profiles and disease severity in patients with cIAI as assessed by the WSESSSS, while the CPIRO was not significantly associated.