Is the Isolation of Associated with Outcomes from Intra-Abdominal Infection? No, But the Receipt of an Empiric Anti-Pseudomonal Agent Is.

is isolated at variable rates from intra-abdominal infections (IAI). Not all recommended empiric regimens for IAI include anti- activity, for example, ceftriaxone and metronidazole. We hypothesized that within an adult population, is a relatively rare isolate and has no association with mortality, and thus, empiric therapy with anti- activity is not warranted. All IAI with positive cultures treated between 1997 and 2017 at a single institution were analyzed. This data set was divided into two cohorts, namely, those with cultures positive for and those without. Demographics and in-hospital mortality were compared by Student t-test and χ analysis. Predictors of isolation of and in-hospital mortality were done by logistic regression (LR) analysis. In total, 2,420 IAIs were identified, 104 (4.3%) with and 2,316 (95.7%) without. Major demographic differences between patients with and those without included a higher rate of health-care-associated infections (87/104, 83.7% vs. 621/2316, 26.8%; p = 0.02), a higher rate of intensive care unit (ICU)-acquired infections (23/104, 22.1% vs. 329/2316, 14.2%; p = 0.04) and a higher Acute Physiology and Chronic Health Evaluation (APACHE) II score (17.7 ± 0.8 vs. 14.5 ± 0.2; p < 0.0001). There was an increased rate of isolation with increasing APACHE II score. Independent predictors of isolation of by LR included APACHE II score and days of hospitalization prior to diagnosis. Crude in-hospital mortality was similar between groups: 14/104 (13.5%) and 276/2316 (11.9%), p = 0.79. After controlling for age, gender, APACHE II, prior transfusion, immunosuppression status, solid organ transplant status, healthcare-association, and days of hospitalization prior to diagnosis, the isolation of was not associated with mortality. is infrequently isolated and overall not associated with mortality. Nonetheless, there may be a population that merits empiric anti- therapy: those with APACHE II ≥20 or a significant length of hospitalization prior to diagnosis.