Antibiotic susceptibility of intra-abdominal infection isolates from Indian hospitals during 2008.

A total of 542 clinical isolates of aerobic Gram-negative bacilli from intra-abdominal infections were collected during 2008 from seven hospitals in India participating in the Study for Monitoring Antimicrobial Resistance Trends (SMART). Isolates were from various infection sources, the most common being gall bladder (30.1 %) and peritoneal fluid (31.5 %), and were mostly hospital-associated isolates (70.8 %) as compared to community-acquired (26.9 %). The most frequently isolated pathogens were Escherichia coli (62.7 %), Klebsiella pneumoniae (16.7 %) and Pseudomonas aeruginosa (5.3 %). Extended-spectrum beta-lactamase (ESBL) rates in E. coli and K. pneumoniae were very high, at 67 % and 55 %, respectively. Most isolates exhibited resistance to one or more antibiotics. The most active drugs were generally ertapenem, imipenem and amikacin. However, hospital-acquired isolates in general, as well as ESBL-positive isolates, exhibited lower susceptibilities than community-acquired isolates. Further surveillance monitoring of intra-abdominal isolates from India is recommended.

[1]  E. P. Dellinger,et al.  Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. , 2010, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[2]  D. Paterson,et al.  Emergence of High Levels of Extended-Spectrum-β-Lactamase-Producing Gram-Negative Bacilli in the Asia-Pacific Region: Data from the Study for Monitoring Antimicrobial Resistance Trends (SMART) Program, 2007 , 2009, Antimicrobial Agents and Chemotherapy.

[3]  Raman Sharma,et al.  Prevalence of extended spectrum beta lactamase and AmpC beta lactamase producers among Escherichia coli isolates in a tertiary care hospital in Jaipur. , 2008, Indian Journal of Pathology and Microbiology.

[4]  V. Lakshmi.  Need for national/regional guidelines and policies in India to combat antibiotic resistance. , 2008, Indian Journal of Medical Microbiology.

[5]  K. Kapila,et al.  Prevalence of extended-spectrum beta-lactamases among Escherichia coli and Klebsiella pneumoniae isolates in a tertiary care hospital. , 2008, Indian Journal of Pathology and Microbiology.

[6]  C. Díaz-Agero Pérez,et al.  Results of the Spanish national nosocomial infection surveillance network (VICONOS) for surgery patients from January 1997 through December 2003. , 2006, American journal of infection control.

[7]  Didier Pittet,et al.  Infection control and quality health care in the new millenium , 2005 .

[8]  J. Griffith,et al.  Risk factors leading to clinical failure in the treatment of intra-abdominal or skin/soft tissue infections , 1996, European Journal of Clinical Microbiology and Infectious Diseases.

[9]  Didier Pittet,et al.  Infection control and quality health care in the new millennium. , 2005, American journal of infection control.

[10]  H. Rüden,et al.  Five years working with the German nosocomial infection surveillance system (Krankenhaus Infektions Surveillance System). , 2003, American journal of infection control.

[11]  J. Coast,et al.  Strategies to contain the emergence of antimicrobial resistance: a systematic review of effectiveness and cost-effectiveness , 2002, Journal of health services research & policy.

[12]  M. Ferraro.  Performance standards for antimicrobial susceptibility testing , 2001 .

[13]  A. Charlett,et al.  A national surveillance scheme for hospital associated infections in England. Team of the Nosocomial Infection National Surveillance Scheme. , 2000, The Journal of hospital infection.

[14]  Dean As,et al.  An operating surveillance system of surgical-site infections in The Netherlands: results of the PREZIES national surveillance network. Preventie van Ziekenhuisinfecties door Surveillance. , 2000 .

[15]  Mary Jane Ferraro,et al.  Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically : approved standard , 2000 .

[16]  E. Wong.  The Price of a Surgical-Site Infection: More Than Just Excess Length of Stay , 1999, Infection Control & Hospital Epidemiology.

[17]  W E Wilkinson,et al.  The Impact of Surgical-Site Infections in the 1990s: Attributable Mortality, Excess Length of Hospitalization, And Extra Costs , 1999, Infection Control & Hospital Epidemiology.

[18]  D. Gerding,et al.  Society for Healthcare Epidemiology of America and Infectious Diseases Society of America Joint Committee on the Prevention of Antimicrobial Resistance: guidelines for the prevention of antimicrobial resistance in hospitals. , 1997, Infection control and hospital epidemiology.

[19]  R. Mertens,et al.  A Computerized Nationwide Network for Nosocomial Infection Surveillance in Belgium , 1994, Infection Control & Hospital Epidemiology.

[20]  D. Dunn,et al.  Antibiotic treatment for surgical peritonitis. , 1991, Annals of surgery.

[21]  J. Solomkin,et al.  Results of a multicenter trial comparing imipenem/cilastatin to tobramycin/clindamycin for intra-abdominal infections. , 1990, Annals of surgery.

[22]  T. Berne,et al.  The role of Pseudomonas species in patients treated with ampicillin and Sulbactam for gangrenous and perforated appendicitis. , 1985, Surgery, gynecology & obstetrics.

[23]  T. Berne,et al.  Antibiotic management of surgically treated gangrenous or perforated appendicitis. Comparison of gentamicin and clindamycin versus cefamandole versus cefoperazone. , 1982, American journal of surgery.