title: Bacteriology of Spontaneous Intra-Abdominal Abscess in Patients with Crohn Disease in China: Risk of Extended-Spectrum Beta-Lactamase-Producing Bacteria.
abstract: BACKGROUND
  Crohn disease (CD) has its own features and the etiology is believed to be related to the gastrointestinal flora, which are the cause of most intra-abdominal infections. However, few experiences have been reported regarding the specific bacteriology of spontaneous intra-abdominal abscess (IAA) in CD patients and related risk factors. In the present study, we aim to investigate the bacteriology of IAA in CD and the associated risk factors.
  
  
  METHODS
  Retrospective study on 97 CD patients suffering from IAA was performed from January 2007 to December 2012. Microbiologic information of pus cultures was pooled, and logistic regression was applied to examine the possible factors affecting the incidence of common organisms and the bacteria producing extended-spectrum beta-lactamase (ESBL).
  
  
  RESULTS
  Of the 97 patients recruited, 151 aerobic bacteria were cultured from the pus of IAA. The leading bacteria were Escherichia coli (57.7%), Klebsiella pneumoniae (19.6%) and Enterococcus faecium (18.6%). Extended-spectrum beta-lactamase-producing bacteria were more commonly found among CD patients receiving immunosuppressant.
  
  
  CONCLUSIONS
  Broad-spectrum antibiotics are recommended for treating IAA in CD. Empirical antibiotic coverage against ESBL-producing bacteria in patients receiving immunosuppressive therapy is advocated. Considering the predominance of Enterococcus faecium, it may be advisable to use more effective antibiotics when gram-positive cocci are suspected.
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University , Nanjing, P.R. China .
authors.forename: Guanwei
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University , Nanjing, P.R. China .
authors.forename: Jianan
authors.initials: J
authors.lastname: Ren
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University , Nanjing, P.R. China .
authors.forename: Qin
authors.initials: Q
authors.lastname: Wu
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University , Nanjing, P.R. China .
authors.forename: Dong
authors.initials: D
authors.lastname: Hu
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University , Nanjing, P.R. China .
authors.forename: Gefei
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University , Nanjing, P.R. China .
authors.forename: Xiuwen
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University , Nanjing, P.R. China .
authors.forename: Song
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University , Nanjing, P.R. China .
authors.forename: Yin
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University , Nanjing, P.R. China .
authors.forename: Guosheng
authors.initials: G
authors.lastname: Gu
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University , Nanjing, P.R. China .
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D018784:Abdominal Abscess / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology*; D000293:Adolescent; D000328:Adult; D001419:Bacteria / Q000187:drug effects / Q000201:enzymology; D002681:China / Q000453:epidemiology; D003424:Crohn Disease / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D059413:Intraabdominal Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult; D018440:beta-Lactam Resistance; D001618:beta-Lactamases
chemical_list: D001618:beta-Lactamases