title: Clinical characteristics of patients with community-acquired complicated intra-abdominal infections: a prospective, multicentre, observational study.
abstract: In this prospective, observational, multicentre study using data from five countries (Columbia, The Philippines, Portugal, Taiwan and Thailand), the clinical impact of extended-spectrum β-lactamase (ESBL)-producing organisms on hospitalised patients with community-acquired complicated intra-abdominal infections (CA-cIAIs) was compared with that of non-ESBL-producing organisms during the period April 2010 to December 2011. Adult patients (aged ≥18 years) requiring surgery or percutaneous drainage were enrolled and were followed during the first hospitalisation course. An unadjusted statistical comparison of risk factors for ESBL-positive and ESBL-negative patients was performed. Multivariate regression analyses were performed to assess whether length of stay (LOS) in hospital, clinical cure rate and some important clinical characteristics were associated with ESBL positivity. During the study period, a total of 105 adult patients from five countries were enrolled, of whom 17 (16.2%) had CA-cIAI due to ESBL-positive organisms and 88 (83.8%) had CA-cIAI due to ESBL-negative organisms. Escherichia coli was isolated in 73.3% of all samples. Infections were cured in 8 (47.1%) of the patients with CA-cIAI due to ESBL-positive organisms and in 59 (67.0%) of the patients with CA-cIAI due to ESBL-negative organisms (P=0.285). The median LOS was 11.6 days for patients with infections due to ESBL-negative organisms and 17.6 days for patients with infections due to ESBL-positive organisms (P=0.011). Multivariate logistic regression analysis revealed that pre-existing co-morbidities, but not ESBL positivity, were adversely associated with clinical cure of CA-cIAIs. In contrast, duration of hospitalisation was longer for patients with CA-cIAI due to ESBL-positive organisms.
authors.affiliation: Department of Emergency Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Shio-Shin
authors.initials: SS
authors.lastname: Jean
authors.affiliation: Department of Medicine at National Cheng Kung University Medical College and Hospital, Tainan, Taiwan.
authors.forename: Wen-Chien
authors.initials: WC
authors.lastname: Ko
authors.affiliation: Merck & Co, Inc., Global Health Outcomes, Whitehouse Station, NJ, USA.
authors.forename: Yang
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Rutgers University, Ernest Mario School of Pharmacy, Piscataway, NJ, USA.
authors.forename: Vaishali
authors.initials: V
authors.lastname: Pawar
authors.affiliation: Merck & Co, Inc., Global Health Outcomes, Whitehouse Station, NJ, USA.
authors.forename: Dongmu
authors.initials: D
authors.lastname: Zhang
authors.affiliation: All Source PPS, Huntington Beach, CA, USA.
authors.forename: Girish
authors.initials: G
authors.lastname: Prajapati
authors.affiliation: Section of Infectious Diseases, Department of Medicine, University of the Philippines, Philippine General Hospital, Taft, Manila, Philippines.
authors.forename: Myrna
authors.initials: M
authors.lastname: Mendoza
authors.affiliation: Department of Microbiology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.
authors.forename: Pattarachai
authors.initials: P
authors.lastname: Kiratisin
authors.affiliation: Clinical Pathology Department, Hospital Infante Dom Pedro - Aveiro, Aveiro, Portugal.
authors.forename: Elmano
authors.initials: E
authors.lastname: Ramalheira
authors.affiliation: Clinical Pathology Department/Microbiology Service, Hospital Geral de Santo António, Porto, Portugal.
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Castro
authors.affiliation: Infectious Diseases, Fundacion Clinica Valle del Lili, Cali, Colombia.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rosso
authors.affiliation: Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, No. 7 Chung-Shan South Road, Taipei 100, Taiwan. Electronic address: hsporen@ntu.edu.tw.
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Hsueh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D017714:Community-Acquired Infections / Q000473:pathology*; D005260:Female; D006801:Humans; D059413:Intraabdominal Infections / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases
keywords: Community-acquired complicated intra-abdominal infection; ESBL; Extended-spectrum β-lactamase; Length of stay; Outcomes