Bacteriology and antibiotic susceptibility of community-acquired intra-abdominal infection in children.
OBJECTIVE
Intra-abdominal infection can be a life-threatening condition in children, and aggressive treatment is usually needed. The treatment should include surgical correction and drainage, and administration of antimicrobials that are effective against both aerobic and anaerobic microorganisms. This study investigated the microbiological characteristics of intra-abdominal infection of children in Taiwan.


METHODS
Data for bacterial specimens from 113 children (64 males), aged from 9 months to 18 years, who had community-acquired intra-abdominal infections at our hospital during a 10-year period were analyzed.


RESULTS
In total, 113 specimens were collected, including those with only aerobes (62%), and those with mixed aerobic and anaerobic species (35%). A total of 239 aerobes and 86 anaerobes were isolated. Polymicrobial infection was found in 79% of specimens. The predominant aerobe was Escherichia coli (42%), and Bacteroides fragilis (36%) was the most frequently isolated anaerobic microorganism. Enterococcus was detected in about 14% of Gram-positive aerobic isolates. Review of the results of antibiotic susceptibility testing revealed that the Gram-positive aerobes, apart from staphylococci, had a high susceptibility rate to ampicillin, and 84% of Gram-negative aerobes were susceptible to gentamicin. In addition, B. fragilis showed a high resistance rate to clindamycin (52%) but all of these isolates were susceptible to metronidazole.


CONCLUSIONS
Triple antibiotic combination therapy including ampicillin, gentamicin and metronidazole remains an alternative empirical antibiotic therapy for pediatric patients with mild to moderate community-acquired intra-abdominal infection.
Lin
Wei Jen
WJ
Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Lo
Wen Tsung
WT
Chu
Chih Chun
CC
Chu
Mong Ling
ML
Wang
Chih Chien
CC
D018784:Abdominal Abscess / Q000188:drug therapy / Q000382:microbiology*; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001064:Appendicitis / Q000382:microbiology; D001420:Bacteria, Aerobic / Q000187:drug effects / Q000302:isolation & purification; D001441:Bacteroides fragilis / Q000187:drug effects / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D004926:Escherichia coli / Q000187:drug effects / Q000302:isolation & purification; D005260:Female; D006095:Gram-Positive Cocci / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007239:Infections / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D008826:Microbial Sensitivity Tests; D010538:Peritonitis / Q000188:drug therapy / Q000382:microbiology*
D000900:Anti-Bacterial Agents