Insights into the microbiology profile of patients with complicated intra-abdominal infections (cIAI) in a tertiary center in Indonesia

Authors:
Adianto Nugroho, Aditomo Widarso, Anti Dharmayanti, Hana Ayu Shafira, Ifael Yerosias Mauleti, Indah Jamtani, Rofi Y Saunat

Body of Abstract:
Abstract
Background. Determining pathogenic etiology and antimicrobial resistance is vital in managing complicated intra-abdominal infections (cIAI), particularly in guiding the use of appropriate empiric antibiotics. This study aims to describe the most commonly isolated pathogens and their resistance patterns in cIAI cases in a single tertiary center in Indonesia.
Methods. This cross-sectional descriptive study analyzed data from patients with cIAI who underwent emergent or elective surgeries at Fatmawati General Hospital (FGH) in Jakarta, Indonesia, between April 2020 and June 2024. One hundred thirty-three cases were reviewed, and 55 intraoperative samples were tested for microbial culture and sensitivity.
Results. Gram-negative bacteria were the most prevalent isolates (n=30, 54.5%), with E. coli (n=19, 63.3%) and K. pneumonia (n=8, 26.7%) being the most commonly identified pathogens. Gram-positive bacteria accounted for eight cases (14.5%), while Candida tropicalis was found in two cases (3.6%). Gram-negative bacteria exhibited the highest sensitivity to carbapenems and amikacin but low sensitivity to penicillin-based antibiotics. Gram-positive bacteria showed moderate sensitivity to penicillin-based antibiotics and the highest sensitivity to tigecycline and linezolid, followed by vancomycin.
Conclusions. Gram-negative bacteria, mainly E. coli, were the most common pathogens in cIAI cases at FGH. They are susceptible to carbapenem and amikacin, making them highly effective options for empiric therapy in these cases. Monitoring microbial resistance patterns is essential to optimizing treatment strategies and combating antimicrobial resistance.