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


OBJECTIVE
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.


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.


CONCLUSIONS
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.
Neetu
N
Shree
Department of Microbiology, Vardhman Mahavir Medical College & Safdarjang Hospital, New Delhi, India.
Balvinder S
BS
Arora
Ravinder S
RS
Mohil
Dimple
D
Kasana
Indu
I
Biswal
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001424:Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005658:Fungi / Q000302:isolation & purification; D006090:Gram-Negative Bacteria / Q000145:classification* / Q000187:drug effects* / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D006784:Hospitals, Teaching; D006801:Humans; D059413:Intraabdominal Infections / Q000453:epidemiology / Q000382:microbiology*; D008826:Microbial Sensitivity Tests; D001618:beta-Lactamases / Q000032:analysis
D000900:Anti-Bacterial Agents; D001618:beta-Lactamases