title: Bacteriology and antimicrobial susceptibility of ESBLs producers from pus in patients with abdominal trauma associated intra-abdominal infections.
abstract: OBJECTIVE
  Intra-abdominal infections (IAIs) caused by ESBLs producing bacteria have become a serious clinical concern worldwide as the prevalence of bacterial resistance to antibiotics continues to increase. The objective of this study was to analyze the bacteriology and antimicrobial susceptibility of ESBLs producers using pus samples from IAIs patients caused by abdominal trauma.
  
  
  METHODS
  A total of 113 pus samples aspirated from IAIs patients were collected. The BACTEC 9120 and Vitek 2 system were used for detecting positive pathogens and confirming ESBLs production. The results of susceptibility were determined following the Clinical Laboratory Standards Institute guidelines.
  
  
  RESULTS
  Among the pathogens causing IAIs, Escherichia coli (E. coli) (29.1 %) was the most commonly isolated, followed by Klebsiella pneumoniae (K. pneumoniae) (22.5 %). The incidence rates of ESBLs production among E. coli, K. pneumoniae, and Klebsiella oxytoca were 69.6, 45.1, and 25.0 %, respectively. All pathogens had high resistance rates against studied antibiotics, with imipenem (88.7 %) and ertapenem (90.7 %) remaining the only practical options. Trend analysis documented an increase in ESBLs producing E. coli and K. pneumoniae, and a decrease in susceptibility for carbapenems among ESBLs producing E. coli and K. pneumoniae.
  
  
  CONCLUSIONS
  Escherichia coli and K. pneumoniae were the major pathogens causing abdominal trauma associated IAIs. The most active agents against ESBLs producing E. coli and K. pneumoniae were ertapenem and imipenem. However, the ESBLs rates were alarmingly high and increasing among IAIs associated gram-negative bacilli infections in China, and most agents exhibited decreased susceptibility against ESBLs producing pathogens.
authors.affiliation: Department of Surgery, Jinling Hospital, Nanjing University School of Medicine, 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: S
authors.initials: S
authors.lastname: Fan
authors.affiliation: Department of Surgery, Jinling Hospital, Nanjing University School of Medicine, 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Surgery, Jinling Hospital, Nanjing University School of Medicine, 305 East Zhongshan Road, Nanjing, 210002, China. liys@medmail.com.cn.
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Surgery, Jinling Hospital, Nanjing University School of Medicine, 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: J
authors.initials: J
authors.lastname: Li
mesh_terms: D000007:Abdominal Injuries / Q000150:complications*; D000293:Adolescent; D000328:Adult; D000368:Aged; D024881:Drug Resistance, Bacterial; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification; D006801:Humans; D059413:Intraabdominal Infections / Q000382:microbiology*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D013492:Suppuration / Q000382:microbiology; D001618:beta-Lactamases / Q000032:analysis*
chemical_list: D001618:beta-Lactamases
keywords: Abdominal trauma; Antimicrobial susceptibility; Bacteriology; ESBLs; Intra-abdominal infections; Pus