Intra-abdominal abscesses: Microbiological epidemiology and empirical antibiotherapy

Infect Dis Now. 2023 Feb;53(1):104604. doi: 10.1016/j.idnow.2022.08.005. Epub 2022 Sep 5.

Abstract

Purpose: 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.

Patients and methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Antibiotic susceptibility; Intra-abdominal abscess; Microbiological epidemiology.

MeSH terms

  • Abdominal Abscess* / drug therapy
  • Abdominal Abscess* / epidemiology
  • Amoxicillin*
  • Anti-Bacterial Agents / therapeutic use
  • Cefotaxime
  • Humans
  • Meropenem
  • Piperacillin, Tazobactam Drug Combination / therapeutic use
  • Retrospective Studies

Substances

  • Meropenem
  • Piperacillin, Tazobactam Drug Combination
  • Amoxicillin
  • Cefotaxime
  • Anti-Bacterial Agents