1 May 2023Article
Evaluation of active microorganisms and antibiotic susceptibility in community-acquired intraabdominal infections in children
Havva Tunay 1Ahmet Tun 2Evrim Boyac 2Recep Kesli 3Neşe Demırturk 1
Affiliations
Article Info
1 Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
2 Department of Pediatric Surgery, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
3 Department of Medical Microbiology, Faculty of Medicine, Selcuk University, Konya, Turkey
Ann. Ital. Chir., 2023, 94(3), 289-294;
Published: 1 May 2023
Copyright © 2023 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
BACKGROUND: In this study, we aimed to investigate the results of intraoperative culture and antibiogram in children who underwent surgery with the diagnosis of community-acquired intraabdominal infections (CA-IAIs) to determine the causative microorganisms and antibiotic susceptibility of the bacterial agents. METHODS: Antibiotic susceptibility of isolated bacteria was investigated with disk diffusion method according to EUCAST (European Committee on Antimicrobial Susceptibility Testing) suggestions directly from the patients’ intraabdominal peritoneal fluid or tissues, aged <18 years. RESULTS: Bacterial growth was found in 17 (34%) of the blood cultures taken before the operation and 38 (76%) of the intraoperative abdominal cultures. According to the isolated strains; 44 (80%) were Gram-negative and 11 (20%) were Gram-positive, however, the most commonly isolated microorganisms were Escherichia coli (52.72%), Klebsiella pneumonia (14.54%), and Enterobacter cloacae (5.45%); extended-spectrum beta-lactamase (ESBL) resistance was detected in 12 of the Escherichia coli strains (41.38%) and the rates of ampicillin-sulbactam, ceftriaxone, and cefotaxime resistance were 43.2%, 40.9%, and 6.8%, respectively. CONCLUSION: In our study, ESBL-resistant gram-negative microorganisms in CA-IAIs presented as primary agents to be considered. Ampicillin-sulbactam, ceftriaxone and cefotaxime should not be preferred in the monotherapy of complicated CA-IAIs due to their high resistance rates, but they can be combined with aminoglycosides. Quinolones can be included in the treatment because of their low resistance rates. It is considered that routine intraoperative culture and evaluation of antibiotic susceptibility in complicated CA-IAIs will provide an insight into the outcomes of empirical treatment.
Keywords
- Antimicrobial resistance
- Intraabdominal infection
- Surgery