Bacteriology and antibiotic susceptibility of community-acquired intra-abdominal infection in children

• Published in: Journal of Microbiology, Immunology and Infection Immunology and Infection, 2006-06, Vol.39 (3), p.249-254
• Main Authors: Lin, Wei Jen, Lo, Wen Tsung, Chu, Chih Chun, Chu, Mong Ling, Wang, Chih Chien
• Format: Article
• Language: English
• Subjects: Abdominal Abscess - drug therapy; Abdominal Abscess - microbiology; Adolescent; Anti-Bacterial Agents - pharmacology; Appendicitis - microbiology; Bacteria, Aerobic - drug effects; Bacteria, Aerobic - isolation & purification; Bacteroides fragilis; Bacteroides fragilis - drug effects; Bacteroides fragilis - isolation & purification; Child; Child, Preschool; Community-Acquired Infections - drug therapy; Community-Acquired Infections - microbiology; Drug Resistance, Microbial; Enterococcus; Escherichia coli; Escherichia coli - drug effects; Escherichia coli - isolation & purification; Female; Gram-Positive Cocci - drug effects; Gram-Positive Cocci - isolation & purification; Humans; Infant; Infection - drug therapy; Infection - microbiology; Male; Microbial Sensitivity Tests; Peritonitis - drug therapy; Peritonitis - microbiology
• ISSN: 1684-1182; 1365-2567

Intra-abdominal infection can be a life-threatening condition in children, and aggressive treatment is usually needed. The treatment should include surgical correction and drainage, and administration of antimicrobials that are effective against both aerobic and anaerobic microorganisms. This study investigated the microbiological characteristics of intra-abdominal infection of children in Taiwan. Data for bacterial specimens from 113 children (64 males), aged from 9 months to 18 years, who had community-acquired intra-abdominal infections at our hospital during a 10-year period were analyzed. In total, 113 specimens were collected, including those with only aerobes (62%), and those with mixed aerobic and anaerobic species (35%). A total of 239 aerobes and 86 anaerobes were isolated. Polymicrobial infection was found in 79% of specimens. The predominant aerobe was Escherichia coli (42%), and Bacteroides fragilis (36%) was the most frequently isolated anaerobic microorganism. Enterococcus was detected in about 14% of Gram-positive aerobic isolates. Review of the results of antibiotic susceptibility testing revealed that the Gram-positive aerobes, apart from staphylococci, had a high susceptibility rate to ampicillin, and 84% of Gram-negative aerobes were susceptible to gentamicin. In addition, B. fragilis showed a high resistance rate to clindamycin (52%) but all of these isolates were susceptible to metronidazole. Triple antibiotic combination therapy including ampicillin, gentamicin and metronidazole remains an alternative empirical antibiotic therapy for pediatric patients with mild to moderate community-acquired intra-abdominal infection.