title: Clinical and microbiological profiles of community-acquired and nosocomial intra-abdominal infections: results of the French prospective, observational EBIIA study.
abstract: OBJECTIVE
  The EBIIA (Etude épidémiologique Bactério-clinique des Infections Intra-Abdominales) study was designed to describe the clinical, microbiological and resistance profiles of community-acquired and nosocomial intra-abdominal infections (IAIs).
  
  
  METHODS
  From January to July 2005, patients undergoing surgery/interventional drainage for IAIs with a positive microbiological culture were included by 25 French centres. The primary endpoint was the epidemiology of the microorganisms and their resistance to antibiotics. Multivariate analysis was carried out using stepwise logistic regression to assess the factors predictive of death during hospitalization.
  
  
  RESULTS
  Three hundred and thirty-one patients (234 community-acquired and 97 nosocomial) were included. The distribution of the microorganisms differed according to the type of infection. Carbapenems and amikacin were the most active agents in vitro against Enterobacteriaceae in both community-acquired and nosocomial infections. Against Pseudomonas aeruginosa, amikacin, imipenem, ceftazidime and ciprofloxacin were the most active agents in community-acquired infections, while imipenem, cefepime and amikacin were the most active in nosocomial cases. Against the Gram-positive bacteria, vancomycin and teicoplanin were the most active in both infections. Against anaerobic bacteria, the most active agents were metronidazole and carbapenems in both groups. Empirical antibiotic therapy adequately targeted the pathogens for 63% of community-acquired and 64% of nosocomial peritonitis. The presence of one or more co-morbidities [odds ratio (OR) = 3.17; P = 0.007], one or more severity criteria (OR = 4.90; P < 0.001) and generalized peritonitis (OR = 3.17; P = 0.006) were predictive of death.
  
  
  CONCLUSIONS
  The principal results of EBIIA are a higher diversity of microorganisms isolated in nosocomial infections and decreased susceptibility among these strains. Despite this, the adequacy of treatment is comparable in the two groups.
authors.affiliation: Département d'Anesthésie Réanimation, CHU Bichat-Claude Bernard, Assistance Publique Hôpitaux de Paris, Université Paris VII, Paris, France. philippe.montravers@bch.aphp.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Montravers
authors.forename: Alain
authors.initials: A
authors.lastname: Lepape
authors.forename: Luc
authors.initials: L
authors.lastname: Dubreuil
authors.forename: Rémy
authors.initials: R
authors.lastname: Gauzit
authors.forename: Yves
authors.initials: Y
authors.lastname: Pean
authors.forename: Daniel
authors.initials: D
authors.lastname: Benchimol
authors.forename: Hervé
authors.initials: H
authors.lastname: Dupont
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001424:Bacterial Infections / Q000382:microbiology* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D017714:Community-Acquired Infections / Q000382:microbiology* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D003428:Cross Infection / Q000382:microbiology* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005602:France; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010538:Peritonitis / Q000382:microbiology* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents