| Autor: |
Hussein IS; Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt., El-Manakhly AR; Department of Microbiology and Immunology, Faculty of Pharmacy, Modern University for Technology and Information, Cairo, Egypt., Salama AS; Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt., Habib AAE; Department of Anesthesia and Intensive Care, Ain Shams University, Cairo, Egypt., Marei T; Department of Anesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt., Elkholy JA; Department of Anesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt., Soliman MS; Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt., El-Kholy AA; Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt. |
| Jazyk: |
angličtina |
| Zdroj: |
Surgical infections [Surg Infect (Larchmt)] 2024 Nov; Vol. 25 (9), pp. 682-690. Date of Electronic Publication: 2024 Aug 22. |
| DOI: |
10.1089/sur.2023.375 |
| Abstrakt: |
Background: Management of complicated intraabdominal infections (cIAIs) requires containment of the source and appropriate initial antimicrobial therapy. Identifying the local data is important to guide the empirical selection of antimicrobial therapy. In this study, we aimed to describe the pathogen distribution and antimicrobial resistance of cIAI. Methods: In two major tertiary care hospitals in Egypt, we enrolled patients who met the case definition of cIAI from October 2022 to September 2023. Blood cultures were performed using the BACTAlert system (BioMerieux, Marcy l'Etoile, France). A culture of aspirated fluid, resected material, or debridement of the infection site was performed. Identification of pathogens and antimicrobial susceptibility testing were conducted by the VITEK-2 system (BioMerieux, Marcy l'Etoile, France). Gram-negative resistance genes were identified by PCR and confirmed by whole bacterial genome sequencing using the Nextera XT DNA Library Preparation Kit and sequencing with the MiSeq Reagent Kit 600 v3 (Illumina, USA) on the Illumina MiSeq. Results: We enrolled 423 patients, 275 (65.01%) males. The median age was 61.35 (range 25-72 years). We studied 452 recovered bacterial isolates. Gram-negative bacteria were the vast majority, dominated by E. coli, followed by Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Proteus mirabilis (33.6%, 30.5%, 13.7%, 13%, and 5.4%, respectively). High rates of resistance were detected to third- and fourth-generation cephalosporins and fluoroquinolones. No resistance was detected to colistin. Resistance to amikacin and tigecycline was low among all isolates. Resistance to meropenem and ceftazidime/avibactam was moderate. ESBL genes were common in E. coli and K. pneumoniae . CTX-M15 gene was the most frequent. Among Enterobacterales, bla OXA-48 and bla NDM were the most prevalent carbapenemase genes. Pseudomonas aeruginosa isolates harbored a wide variety of carbapenemase genes (OXA, NDM, VIM, SIM, GIM, SPM, IMP, AIM), dominated by metallo-beta-lactamases. In 20.6% of isolates, we identified two or more resistance genes. Conclusion: High resistance rates were detected to third- and fourth-generation cephalosporins and fluoroquinolones. Amikacin and tigecyclines were the most active antimicrobials. Our data call for urgent implementation of antimicrobial stewardship programs and reinforcement of infection control. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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