Diagnóstico microbiológico de las infecciones intraabdominales

Garcı́a-Sánchez, José Elı́as; García-García, M. Inmaculada; Garcı́a-Garrote, Fernando; Sánchez-Romero, Isabel

doi:10.1016/j.eimc.2012.01.023

Cited by 18 publications

(9 citation statements)

References 18 publications

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“…and fungi [ 5 ]. In our population, there was an increased presence of multidrug-resistant pathogens and fungal SSI rates when compared with other series [ 17 , 18 ]. This could be explained by the higher antibiotic pressure, use of broad-spectrum antibiotics, illness severity and prolonged treatment periods.…”

Section: Discussionmentioning

confidence: 44%

Surgical site infection in critically ill patients with secondary and tertiary peritonitis: epidemiology, microbiology and influence in outcomes

et al. 2015

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BackgroundSurgical site infection (SSI) remains a significant problem in the postoperative period that can negatively affect clinical outcomes. Microbiology findings are typically similar to other nosocomial infections, with differences dependent on microbiology selection due to antibiotic pressure or the resident flora. However, this is poorly understood in the critical care setting. We therefore aimed to assess the incidence, epidemiology and microbiology of SSI and its association with outcomes in patients with severe peritonitis in the intensive care unit (ICU).MethodsWe prospectively studied 305 consecutive patients admitted to our surgical ICU from 2010 to 2014 with a diagnosis of secondary or tertiary peritonitis. We collected the following data: SSI diagnosis, demographics, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Simplified Acute Physiology Score (SAPS) II score, type of surgery, microbiology, antibiotic treatment and outcomes. Microbiological sampling was done by means of swabs.ResultsWe identified 269 episodes of SSI in 162 patients (53.1 %) aged 64.4 ± 14.3 years, of which 200 episodes occurred in men (64.6 %). The mean APACHE II and SAPS II scores were 19.7 ± 7.8 and 36.5 ± 16.1 respectively. The mean ICU and hospital stays were 19.8 ± 24.8 and 21.7 ± 30 days respectively. Pseudomonas spp. (n = 52, 19.3 %), Escherichia coli (n = 55, 20.4 %) and Candida spp. (n = 46, 17.1 %) were the most frequently isolated microorganisms, but gram-positive cocci (n = 80, 29.7 %) were also frequent. Microorganisms isolated from SSIs were associated with a higher incidence of antibiotic resistance (64.9 %) in ICU patients, but not with higher in-hospital mortality. However, patients who suffered from SSI had longer ICU admissions (odds ratio = 1.024, 95 % confidence interval 1.010–1.039, P = 0.001).ConclusionsThe incidence of SSI in secondary or tertiary peritonitis requiring ICU admission is very high. Physicians may consider antibiotic-resistant pathogens, gram-positive cocci and fungi when choosing empiric antibiotic treatment for SSI, although more studies are needed to confirm our results due to the inherent limitations of the microbiological sampling with swabs performed in our research. The presence of SSI may be associated with prolonged ICU stays, but without any influence on overall mortality.

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Section: Discussionmentioning

confidence: 44%

Surgical site infection in critically ill patients with secondary and tertiary peritonitis: epidemiology, microbiology and influence in outcomes

et al. 2015

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“…The microorganisms found as the pattern in the epidemiology predominated by Escherichia coli and Klebsiella pneumonia. Escherichia coli which microorganism in the ecosystem of gastrointestinal tract particularly ileum; 20 a little bit higher than reported by Garcia-Sanchez, et al in 2013 21,22 but lower than reported by de Ruiter et al in 2009 18 As perforated appendicitis is the major finding in cIAI, it might be explaining why Escherichia coli is the microorganism found. However, this commensal microorganism reveals different manifestation as it comprising three main subsets, 23,24 namely commensal strains innocuously colonize the colon of healthy hosts, causing extraintestinal disease when a large inoculum and/or significant host compromise found such as in cIAI, diarrhoeagenic strains, and extraintestinal pathogenic Escherichia coli (ExPEC) [25][26][27] often innocuously colonize the human gut which have a unique ability to enter and survive within normally sterile extraintestinal body sites, and to cause disease when they do so.…”

Section: Discussionmentioning

confidence: 65%

Epidemiology of Microorganisms in intraabdominal infection/complicated intraabdominal infections in six centers of surgical care in Indonesia: A preliminary study

Moenadjat

Lalisang

Saunar

et al. 2017

NRJS

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Introduction. Data of complicated intraabdominal infections (cIAI) and the epidemiology of causative microorganisms which is Indonesian characteristics is required to develop a guideline. Thus, a preliminary study run to find out such characteristics. Method. Data of subjects with cIAI managed in six centers of teaching hospital in Indonesia in period of 2015-2016 were collected. Those data of source of infection, the epidemiology of microorganism and susceptibility of antibiotics were descriptively provided. Results. Source of infection were perforated appendicitis (26.64%), perforated gastric and duodenal ulcer (22.70%), small bowel perforation (11.84%), large bowel perforation (13.16%), postoperative (9.54%), and others (16.2%). Escherichia coli and Klebsiella pneumonia were the most microorganisms found in the pus specimen. The sensitivity of Escherichia coli and Klebsiella pneumonia to cephalosporins were in range of 14.1-42% and 28.7-35.6%, respectively. Conclusion. Perforated appendicitis, perforated gastric and duodenal ulcer, small bowel perforation, large bowel perforation, and postoperative in sequent are the main causal of cIAI in Indonesia. The epidemiology predominated by Gram negative, particularly Escherichia coli and Klebsiella pneumonia.

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“…El tratamiento de las IIA consiste en control del sitio de infección, lo que por lo general se logra con procedimientos invasivos o mínimamente invasivos y con tratamiento antibiótico empírico, los que pueden variar dependiendo del órgano afectado, grado de repercusión sistémica, riesgo de existencia de patógenos resistentes y características propias del paciente 7 . El diagnóstico microbiológico de la mayoría de las IIA es directo, utilizándose cultivos y estudio de sensibilidad a antibióticos para así poder optimizar resultados terapéuticos 8 .…”

Section: Introductionunclassified

Hallazgos Microbiológicos Y Susceptibilidad Antimicrobiana en Cirugía Abdominal De Urgencia.

et al. 2020

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Introducción: Es importante mantener programas de vigilancia bacteriana para disminuir resistencia y definir esquemas farmacológicos adecuados. Los pacientes con abdomen agudo representan un grupo microbiológico especial.Objetivos: Hacer una revisión de agentes patógenos en pacientes adultos operados en nuestro Servicio de Urgencia por patología abdominal con líquido libre y analizar los resultados obtenidos de cultivos respecto a las cepas y la suceptibilidad a los antibióticos. Materiales y Método: Estudio de cohorte prospectiva con estadística descriptiva. Se incluyen pacientes consecutivos, mayores de 18 años, operados por abdomen agudo que presentan liquido libre intraperitoneal entre noviembre de 2017 y abril de 2018.Se excluyen casos con terapia antimicrobiana, hospitalización y/o cirugía en los 3 meses previos. Se registran los cultivos positivos, cepas aisladas, susceptibilidad antimicrobiana, datos demográficos y evolución clínica.Resultados: De 63 pacientes 55% fueron hombres y la edad promedio 52,2 años. Las patologías más frecuentes fueron de origen apendicular (62%) y de causa entérica (30%). En un 44% el cultivo fue positivo y en 36% con más de un germen. Escherichia coli fue el patógeno más frecuente (64,2%) seguidos de Enterococo faecium y Estreptococo anginosus (7,1%). De los otros patógenos cultivados sólo se observó resistencia múltiple en un caso aislado de Morganella Morganii.Conclusiones: Estos datos constituyen la realidad microbiológica local en abdomen agudo. La Escherichia Coli sigue siendo el germen más frecuente, debe enfrentarse con profilaxis y tratamiento antibiótico adecuado. Es necesario mantener vigilancia microbiología local para un manejo acorde.

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Diagnóstico microbiológico de las infecciones intraabdominales

Cited by 18 publications

References 18 publications

Surgical site infection in critically ill patients with secondary and tertiary peritonitis: epidemiology, microbiology and influence in outcomes

Surgical site infection in critically ill patients with secondary and tertiary peritonitis: epidemiology, microbiology and influence in outcomes

Epidemiology of Microorganisms in intraabdominal infection/complicated intraabdominal infections in six centers of surgical care in Indonesia: A preliminary study

Hallazgos Microbiológicos Y Susceptibilidad Antimicrobiana en Cirugía Abdominal De Urgencia.

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