Nicoletti Giuseppe, Nicolosi Daria, Rossolini Gian Maria, Stefani Stefania
Dipartimento di Scienze Microbiologiche e Scienze Ginecologiche, Universita degli Studi di Catania, Italy.
Infez Med. 2008 Feb;16 Suppl 1:8-18.
Intra-abdominal infections (IAIs) are commonly encountered in clinical practice. The etiology of these infections, often polymicrobial in nature, can be variable and usually includes organisms derived from the gut microbiota. In community-acquired IAIs enterobacteria predominate (mostly Escherichia coli) in combination with anaerobes (mostly Bacteroides fragilis). In nosocomial IAIs, which can complicate abdominal surgery, other pathogens can also play a role, such as Pseudomonas aeruginosa, Acinetobacter baumannii, Staphylococcus aureus, Enterococcus spp. e Candida spp. Diagnostic microbiology of IAIs is complex and plays a relevant role especially in some situations (e. g. presence of foreign bodies, potential presence of resistant or uncommon pathogens, nosocomial infections in subjects with risk factors). Antibiotic resistance issues are currently encountered in most pathogenic species causing IAIs. Resistance affects all major classes of antimicrobial agents, often involving multiple classes and resulting in complex resistance phenotypes for which only a very limited number of drugs remain active.
腹腔内感染（IAIs）在临床实践中很常见。这些感染的病因通常具有多种微生物，可能各不相同，通常包括源自肠道微生物群的生物体。在社区获得性IAIs中，肠杆菌占主导（主要是大肠杆菌），并伴有厌氧菌（主要是脆弱拟杆菌）。在可能使腹部手术复杂化的医院获得性IAIs中，其他病原体也可能起作用，如铜绿假单胞菌、鲍曼不动杆菌、金黄色葡萄球菌、肠球菌属和念珠菌属。IAIs的诊断微生物学很复杂，尤其在某些情况下（例如存在异物、可能存在耐药或不常见病原体、有危险因素的患者发生医院感染）发挥着重要作用。目前在引起IAIs的大多数致病物种中都遇到了抗生素耐药性问题。耐药性影响所有主要类别的抗菌药物，通常涉及多个类别，并导致复杂的耐药表型，对此只有极少数药物仍然有效。
