Intra-Abdominal Infections: Prevalence and Risk Factors of ESBLs Infections.

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 ofpatients 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 ofpatients 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.