Infectious Disease Department, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France; IAME, INSERM UMR 1137, Université Sorbonne Paris Nord, Sorbonne Paris Cité, France.
Infectious Disease Department, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France.
Infect Dis Now. 2023 Feb;53(1):104604. doi: 10.1016/j.idnow.2022.08.005. Epub 2022 Sep 5.
Data on the microbiological epidemiology of Intra-Abdominal Abscesses (IAAs) are very scarce. We aimed to study the microbiological epidemiology of these infections in order to optimize empirical antibiotic therapy.
Between January 2015 and December 2020, we retrospectively analyzed all IAAs files in our hospital. Clinical and microbiological data such as antibiotic susceptibilities were collected.
We studied 243 IAA cases. All in all, 139 (57.2%) IAAs were healthcare-associated and 201 (82.7%) were drained. The highest risk situations for IAAs were appendicitis (n = 69) and diverticulitis (n = 37). Out of the 163 microbiologically documented infections, 136 (81.9%) were polymicrobial. Enterobacterales (n = 192, 36.1%), Enterococcus sp. (n = 84, 17.6%) and anaerobes (n = 66, 16.1%) were the most frequently identified bacteria. Gram-negative bacteria were susceptible to amoxicillin-acid clavulanic, piperacillin-tazobactam, cefotaxime, meropenem in 55.2%, 84.9%, 77.6% and 99.5% of cases, respectively. Concerning Gram-positive bacteria, the susceptibility rate was 81.8% for amoxicillin-clavulanic acid, piperacillin-tazobactam and meropenem, and decreased to 63.4% for cefotaxime.
This study highlights the polymicrobial profile of IAAs and their low susceptibility to amoxicillin and clavulanic acid. The piperacillin-tazobactam association remained the most appropriate empirical antibiotic therapy.
关于腹腔脓肿（IAAs）的微生物流行病学数据非常有限。我们旨在研究这些感染的微生物流行病学，以优化经验性抗生素治疗。
我们回顾性分析了 2015 年 1 月至 2020 年 12 月期间我院所有的 IAAs 病历。收集了临床和微生物学数据，如抗生素药敏性。
我们研究了 243 例 IAA 病例。所有的 IAA 中有 139 例（57.2%）与医疗保健相关，201 例（82.7%）进行了引流。IAAs 的最高风险情况是阑尾炎（n=69）和憩室炎（n=37）。在 163 例微生物学确诊的感染中，136 例（81.9%）为混合感染。肠杆菌科（n=192，36.1%）、肠球菌属（n=84，17.6%）和厌氧菌（n=66，16.1%）是最常鉴定出的细菌。革兰氏阴性菌对阿莫西林-克拉维酸、哌拉西林-他唑巴坦、头孢噻肟、美罗培南的敏感性分别为 55.2%、84.9%、77.6%和 99.5%。对于革兰氏阳性菌，阿莫西林-克拉维酸、哌拉西林-他唑巴坦和美罗培南的敏感性率为 81.8%，而头孢噻肟的敏感性率则下降至 63.4%。
本研究强调了 IAAs 的多微生物特征及其对阿莫西林和克拉维酸的低敏感性。哌拉西林-他唑巴坦联合用药仍然是最合适的经验性抗生素治疗。
