Causative Microorganisms Isolated from Patients with Intra-Abdominal Infections and Their Drug Resistance Profiles: An 11-Year (2011-2021) Single-Center Retrospective Study.

Rui Ding; Rui Rui MA; Ya Li Liu; Ying Zhao; Li Na Guo; Hong Tao Dou; Hong Li Sun; Wen Jing Liu; Li Zhang; Yao Wang; Ding Ding LI; Qiao Lian YI; Ying Chun XU

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Causative Microorganisms Isolated from Patients with Intra-Abdominal Infections and Their Drug Resistance Profiles: An 11-Year (2011-2021) Single-Center Retrospective Study.

Author: Rui DING ^{1
,

2} ; Rui Rui MA ^{1
,

2} ; Ya Li LIU ^{1
,

3
,

4} ; Ying ZHAO ^{1
,

2} ; Li Na GUO ^{1
,

2} ; Hong Tao DOU ^{1
,

2} ; Hong Li SUN ^{1
,

2} ; Wen Jing LIU ^{1
,

2} ; Li ZHANG ^{1
,

2} ; Yao WANG ^{1
,

2} ; Ding Ding LI ^{1
,

2} ; Qiao Lian YI ^{1
,

2} ; Ying Chun XU ^{1
,

3
,

4}
Author Information

1. Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
2. Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing 100730, China.
3. Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing 100730, China
4. Graduate School, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Publication Type:Journal Article
Keywords: Antimicrobial susceptibility testing; Causative microorganisms; Gram-negative bacteria; Gram-positive bacteria; Intra-abdominal infection
MeSH: Humans; Anti-Bacterial Agents; Escherichia coli; Gram-Negative Bacteria; Gram-Positive Bacteria; Retrospective Studies; Staphylococcus aureus; Intraabdominal Infections/epidemiology*; Candida albicans; Coinfection
From: Biomedical and Environmental Sciences 2023;36(8):732-742
CountryChina
Language:English
Abstract: OBJECTIVE:To investigate the distribution and antimicrobial susceptibility of causative microorganisms recovered from patients with intra-abdominal infections (IAIs).
METHODS:A total of 2,926 bacterial and fungal strains were identified in samples collected from 1,679 patients with IAIs at the Peking Union Medical College Hospital between 2011 and 2021. Pathogenic bacteria and fungi were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antimicrobial susceptibility testing (AST) was performed using the VITEK 2 compact system and the Kirby-Bauer method. AST results were interpreted based on the M100-Ed31 clinical breakpoints of the Clinical and Laboratory Standards Institute.
RESULTS:Of the 2,926 strains identified, 49.2%, 40.8%, and 9.5% were gram-negative bacteria, gram-positive bacteria, and fungi, respectively. Escherichia coli was the most prevalent pathogen in intensive care unit (ICU) and non-ICU patients; however, a significant decrease was observed in the isolation of E. coli between 2011 and 2021. Specifically, significant decreases were observed between 2011 and 2021 in the levels of extended-spectrum β-lactamase (ESBL)-producing E. coli (from 76.9% to 14.3%) and Klebsiella pneumoniae (from 45.8% to 4.8%). Polymicrobial infections, particularly those involving co-infection with gram-positive and gram-negative bacteria, were commonly observed in IAI patients. Moreover, Candida albicans was more commonly isolated from hospital-associated IAI samples, while Staphylococcus epidermidis had a higher ratio in community-associated IAIs. Additionally, AST results revealed that most antimicrobial agents performed better in non-ESBL-producers than in ESBL-producers, while the overall resistance rates (56.9%-76.8%) of Acinetobacter baumanmii were higher against all antimicrobial agents than those of other common gram-negative bacteria. Indeed, Enterococcus faecium, Enterococcus faecalis, S. epidermidis, and S. aureus were consistently found to be susceptible to vancomycin, teicoplanin, and linezolid. Similarly, C. albicans exhibited high susceptibility to all the tested antifungal drugs.
CONCLUSION:The distribution and antimicrobial susceptibility of the causative microorganisms from patients with IAIs were altered between 2011 and 2021. This finding is valuable for the implementation of evidence-based antimicrobial therapy and provides guidance for the control of hospital infections.