Intra-Abdominal Infection (Sub-Category)

Factors associated with multidrug-resistant bacteria in secondary peritonitis: impact on antibiotic therapy

P Seguin
B Laviolle
C Chanavaz
PY Donnio
AL Gautier-Lerestif
JP Campion
Y Mallédant

ABSTRACT

 

Secondary peritonitis includes community-acquired and nosocomial peritonitis.  These intra-abdominal infections have a common pathogenesis but some microbiological differences, particularly with respect to the type of bacteria recovered and the level of antimicrobial susceptibility.  This report describes a prospective observational study of 93 consecutive patients with secondary peritonitis during an 11-month period.  Community-acquired peritonitis accounted for 44 cases and nosocomial peritonitis for 49 cases (post-operative in 35 cases).  Fifteen multidrug-resistant (MDR) bacteria were recovered from 14 patients.  In univariate analysis, the presence of MDR bacteria was associated significantly with pre-operative and total hospital lengths of stay, previous use of antimicrobial therapy, and post-operative antimicrobial therapy duration and modifications.  A five-day cut-off in length of hospital stay had the best specificity (58%) and sensitivity (93%) for predicting whether MDR bacteria were present.  In multivariate analysis, only a composite variable associating pre-operative hospital length of stay and previous use of antimicrobial therapy was a significant independent risk-factor for infection with MDR bacteria.  In conclusion, knowledge of these two factors may provide a more rational basis for selecting initial antimicrobial therapy for patients with secondary peritonitis.

 

PubMed Link to Article:

Seguin P, Laviolle B, Chanavaz C, Donnio PY, Gautier-Lerestif AL, Campion JP, Mallédant Y. Factors associated with multidrug-resistant bacteria in secondary peritonitis: impact on antibiotic therapy. Clin Microbiol Infect. 2006 Oct;12(10):980-5. PubMed PMID: 16961634.