Journal of Gastrointestinal Infections

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VOLUME 7 , ISSUE 1 ( 2017 ) > List of Articles


Bacteriological Profile and Antimicrobial Susceptibility Pattern of Intra-abdominal Infections: A Study from a Tertiary Care Hospital of North India

Ritu Garg, Varsha A Singh

Keywords : Emerging resistance, Empirical antimicrobials, Intra-abdominal infections.

Citation Information : Garg R, Singh VA. Bacteriological Profile and Antimicrobial Susceptibility Pattern of Intra-abdominal Infections: A Study from a Tertiary Care Hospital of North India. J Gastrointest Infect 2017; 7 (1):21-25.

DOI: 10.5005/jogi-7-1-21

License: CC BY-SA 4.0

Published Online: 01-11-2015

Copyright Statement:  Copyright © 2017; The Author(s).


Background and objectives: Intra-abdominal infections (IAIs) are associated with significant morbidity and mortality. Pathogenic isolates and emerging resistance to commonly used antimicrobials have been a matter of concern in IAIs. In the present study, bacteriological profile and antimicrobial susceptibility of isolates from IAIs were investigated. Materials and methods: A total of 145 samples (ascitic fluids, n = 56; bile, n = 20; and pus, n = 36) were collected from suspected IAI of patients reporting to the hospital and cultured. Identification of the isolates was done using standard identification protocol. Antimicrobial susceptibility was performed by Kirby-Bauer disk diffusion method and interpretation was done according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Of 145 samples, 112 were culture positive and 33 were sterile. Gram-negative organisms (n = 85) outnumbered the Gram-positive organisms (n = 27). Among the Gramnegative organisms, Escherichia coli (n = 31) was the most commonly isolated organism followed by Klebsiella sp. (n = 19), Acinetobacter sp. (n = 14), Pseudomonas sp. (n = 10), Proteus sp. (n = 5), Citrobacter sp. (n = 3), and Enterobacter sp. (n = 3). Among the Gram-positive bacteria, the most common organism was Staphylococcus aureus (n = 19) followed by Enterococcus faecalis (n = 8). Gram-negative bacilli showed significant resistance to almost all of the commonly used antibiotics. The rate of methicillin-resistant S. aureus (MRSA) was 36.84%. Conclusion: Prompt starting of empirical antimicrobials based on the local susceptibility pattern, followed by modification of treatment in accordance with the antimicrobial susceptibility report can significantly reduce the morbidity and the mortality associated with IAIs.

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  1. Sartelli M, Catena F, Ansaloni L, Leppaniemi A, Taviloglu K, van Goor H, Viale P, Lazzareschi DV, Coccolini F, Corbella D, et al. Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study. World J Emerg Surg 2012 Nov;7(1):36.
  2. Saad U, Anwar S, Kahara UZ, Siddiqui M, Saeed H. Antimicrobial susceptibility of intra-abdominal infection isolates from a tertiary care hospital in Karachi. J Ayub Med Coll Abbottabad 2016 Jul-Sep;28(3):568-571.
  3. Mazukim JE, Solomon JS. Intra-abdominal infections. Surg Clin North Am 2009 Apr;89(2):421-437.
  4. Sartelli M, Catena F, Ansaloni L, Moore E, Malangoni M, Velmahos G, Coimbra R, Koike K, Leppaniemi A, Biffl W, et al. Complicated intra-abdominal infections in a worldwide context: an observational prospective study (CIAOW Study). World J Emerg Surg 2013 Jan;8(1):3-7.
  5. Colle JG, Miles RS, Watt B. Tests for identification of bacteria. In: Collee JG, editors. Mackie and McCartney Practical medical microbiology. 14th ed. Edinburgh: Churchill Livingstone;1996. pp. 151-179.
  6. Ananthanarayan R, Jayaram Paniker CK. Urinary tract infections. In: Kapil A, editor. Text book of microbiology. 9th ed. Hyderabad, India: University Press; 2013. p. 671.
  7. Sastry AS, Bhat SK. Clinical microbiology (infective syndrome). In: Essentials of medical microbiology. 1st ed. Delhi: JAYPEE Publications; 2016. pp. 585-588.
  8. Bauer AW, Kirby WMM, Sherris JC, Jurck M. Antibiotic susceptibility testing by a standardized single disc method. Am J Clin Pathol 1966 Apr;45(4):493-496.
  9. CLSI. Performance standards for antimicrobial susceptibility testing; 23rd Informational Supplement. CLSI Document M100-S23, Wayne PA: Clinical and Laboratory Standards Institute; 2013.
  10. European Committee on Antimicrobial Susceptibility Testing (EUCAST). Breakpoint tables for interpretation of MICs and zone diameters, version 1.1. Stockholm, Sweden: EUCAST; 2010.
  11. Kurup A, Liau KH, Ren J, Lu MC, Navarro NS, Farooka MW, Usman N, Destura RV, Sirichindakul B, Tantawichien T, et al. Antibiotic management of complicated intra-abdominal infections in adults: The Asian perspective. Ann Med Surg 2014 Aut;3(3):85-91.
  12. Hawser SP, Badal RE, Bouchillon SK, Hoban DJ. Antibiotic susceptibility of intra-abdominal infection isolates from Indian hospitals during 2008. J Med Microbiol 2010 Sep; 59(9):1050-1054.
  13. Shree N, Arora BS, Mohil RS, Kasana D, Biswal I. Bacterial profile and patterns of antimicrobial drug resistance in intra-abdominal infections: Current experience in a teaching hospital. Indian J Pathol Microbiol. 2013 Jan;56(4):388-392.
  14. Oteo J, Lazaro E, de Abajo FJ, Baquero F, Campos J. Antimicrobial resistant invasive Escherichia coli, Spain. Emerg Infect Dis 2005 Apr;11(4):546-553.
  15. Datta P, Gulati N, Singla N. Vasudeva HR, Bala K, Chander J, Gupta V. Evaluation of various methods for the detection of methicillin-resistant Staphylococcus aureus strains and susceptibility patterns. J Med Microbiol 2011 Nov;60(Pt 11):1613-1616.
  16. Montravers P, Lepape A, Dubreuil L, Gauzit R, Pean Y, Benchimol D, Dupont H. Clinical and microbiological profiles of community acquired and nosocomial intra-abdominal infections: Result of the French prospective, observational EBIIA study. J Antimicrob Chemother 2009 Apr;63(4): 785-794.
  17. Akhter J, Ahmed S, Anwar S. Antimicrobial Susceptibility Patterns of Enterococcus species Isolated from urinary tract infections. Bangladesh J Med Microbiol 2014;8(1):16-20.
  18. Chaudhary U, Shamma M, Yadav A. Antimicrobial susceptibility patterns of common and unusual Enterococcus species isolated from clinical specimens. J Infect Dis Antimicrob Agents 2007 Jan;24(2):55-62.
  19. Huidrom S, Narayanaswamy G, Dadlani R. Detection of highlevel aminoglycoside resistant pattern of Enterococci isolated from urine samples at a tertiary care hospital in Bengaluru. Ann Trop Med Public Health 2016 May;9(3):165-169.
  20. Gupta V, Singla N, Behl P, Sahoo T, Chander J. Antimicrobial susceptibility pattern of vancomycin resistant enterococci to newer antimicrobial agents. Indian J Med Res 2015 Apr;141(4):483-486.
  21. Chitnis S, Katara G, Hemvani N, Pareek S, Chitnis DS. In vitro activity of daptomycin & linezolid against methicillin resistant Staphylococcus aureus & vancomycin resistant enterococci isolated from hospitalized cases in Central India. Indian J Med Res 2013 Jan;137(1):191-196.
  22. Manoharan A, Chatterjee S, Madhan S, Mathai D. Evaluation of tigecycline activity in clinical isolates among Indian medical centers. Indian J Pathol Microbiol 2010 Oct-Dec;53(4):734-737.
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