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Bacteriology and antimicrobial susceptibility of ESBLs producers from pus in patients with abdominal trauma associated intra-abdominal infections

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

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.

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Authors and Affiliations

  1. Department of Surgery, Jinling Hospital, Nanjing University School of Medicine, 305 East Zhongshan Road, Nanjing, 210002, China

    S. Fan, J. Wang, Y. Li & J. Li

Authors
  1. S. Fan
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  2. J. Wang
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  3. Y. Li
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  4. J. Li
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Corresponding author

Correspondence to Y. Li.

Ethics declarations

This retrospective study was designed according to the ethical principles outlined by the Declaration of Helsinki and approved by the local ethic’s committee of Jinling Hospital to investigate the epidemiology and susceptibility levels for ESBLs producing bacteria in patients with abdominal trauma associated IAIs. All the participants provided written informed consent.

Conflict of interest

Shengxian Fan, Jian Wang, Yousheng Li, and Jieshou Li declare that they have no conflict of interest.

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This work received no sources of funding.

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Fan, S., Wang, J., Li, Y. et al. Bacteriology and antimicrobial susceptibility of ESBLs producers from pus in patients with abdominal trauma associated intra-abdominal infections. Eur J Trauma Emerg Surg 43, 65–71 (2017). https://doi.org/10.1007/s00068-016-0650-0

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  • DOI: https://doi.org/10.1007/s00068-016-0650-0

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