Intra-Abdominal Infections: Prevalence and Risk
Factors of ESBLs Infections
Pisake Boontham MD, PhD*,
Rattaphon Soontornrak MD*
Affiliation :
* Department of Surgery, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
Background : Extended-Spectrum Beta-Lactamases (ESBLs)-producing bacteria are increasing challenge in the treatment
of both community acquired and nosocomial intra-abdominal infections (IAIs). Investigating the characteristics of patients
with the IAIs caused by ESBL-producing bacteria and assessing the risk factors of ESBLs infection will lead to appropriate
therapeutic management.
Objective : To determine prevalence of ESBL-producing bacteria in IAIs in Phramongkutklao Hospital and identify risk
factor of the ESBL-infections.
Material and Method: We performed a retrospective cross sectional study of patients admitted in Phramongkutklao Hospital
between January 1 and December 30, 2012 to determine the prevalence and risk factors acquiring ESBL-producing bacteria
in IAIs and the outcomes of these infections.
Results : Sixty-one patients were studied, of whom 45 (73.8%) had community-acquired and 16 (26.2%) had nosocomial
IAIs. ESBL-producing bacteria were positive in 18 patients, 7 (15.6%) in community acquired and 11 (68.8%) nosocomial
infection. The common gram negative bacilli were Escherichia coli, Klebsiella pneumoniae. Univariate analysis showed
three factors including nosocomial infection, prior admission within one month, and prior use of antibiotics, in particular,
cephalosporin, and beta-lactam/beta-lactamase inhibitor (BLBI), to be associated with ESBL-producing bacterial infections.
In the multivariate analysis, nosocomial infection (odds ratio [OR], 5.26; 95% confidence interval [CI], (1.07-25.88);
p = 0.041) was independent factor that related to the ESBL-infection in IAIs.
Conclusion : Nosocomial infection was found as an independent factor significantly associated with ESBL-infection in IAIs.
Other critical issues remain debatable and more controversial are due to the limited number of the study’s patients.
Keywords : Intra-abdominal infections, Extended-spectrum beta-lactamases, Nosocomial, E. coli
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