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 β-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.
AgrawalP.,
GhoshA. N.,
KumarS.,
BasuB.,
KapilaK.2008; Prevalence of extended-spectrum-beta-lactamases among Escherichia coli and Klebsiella pneumoniae isolates in a tertiary care hospital. Indian J Pathol Microbiol 51:139–142[CrossRef]
BerneT. V.,
YellinA. W.,
ApplemanM. D.,
HeseltineP. N.1982; Antibiotic management of surgically treated gangrenous or perforated appendicitis: comparison of gentamicin and clindamycin versus cefamandole versus cefoperazone. Am J Surg 144:8–13[CrossRef]
FalagasM. E.,
BarefootL.,
GriffithJ.,
RuthazarR.,
SnydmanD. R.1996; Risk factors leading to clinical failure in the treatment of intra-abdominal or skin/soft tissue infections. Eur J Clin Microbiol Infect Dis 15:913–921[CrossRef]
GastmeierP.,
GeffersC.,
SohrD.,
DettenkoferM.,
DaschnerF.,
RudenH.2003; Five years working with the German nosocomial infection surveillance system (Krankenhaus Infektions Surveillance System). Am J Infect Control 31:316–321[CrossRef]
GeubbelsE. L.,
Mintjes-de-GrootJ. A.,
van de BergJ. M.,
de BoerA. S.2000; An operating surveillance system of surgical-site infections in the Netherlands: results of the PREZIES National Surveillance Network. Infect Control Hosp Epidemiol 21:311–318[CrossRef]
HawserS. P.,
BouchillonS. K.,
HobanD. J.,
BadalR. E.,
HsuehP.-R.,
PatersonD. L.2009; Emergence of high levels of extended-spectrum-beta-lactamase-producing Gram-negative bacilli in the Asia-Pacific region: data from the Study for Monitoring Antimicrobial Resistance Trends (SMART) program, 2007. Antimicrob Agents Chemother 53:3280–3284[CrossRef]
JodraV. M.,
PerezC.,
de los Terreros SolerL. S.,
Saa RequejoC. M.,
BallesterosD. D.2006; Results of the Spanish National Nosocomial Infection Surveillance network (VICONOS) for surgery patients from; January 1997 through December 2003Am J Infect Control 34:134–141[CrossRef]
KirklandK. B.,
BriggsJ. P.,
TrivetteS. H. L.,
WilkinsonW. E.,
SextonD. J.1999; The impact of surgical site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol 20:725–730[CrossRef]
LakshmiV.2008; Need for national/regional guidelines and policies in India to combat antibiotic resistance. Indian J Med Microbiol 26:105–107[CrossRef]
MertensR.,
JansB.,
KurzX.1994; A computerized nationwide network for nosocomial infection surveillance in Belgium. Infect Control Hosp Epidemiol 15:171–179[CrossRef]
ShlaesD. M.,
GerdingD. N.,
JohnJ. F.1997; 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. Clin Infect Dis 25:584–599[CrossRef]
SinhaP.,
SharmaR.,
RishiS.,
SharmaR.,
SoodS.,
PathakD.2008; Prevalence of extended spectrum beta-lactamases and AmpC beta-lactamase producers among Escherichia coli isolates in a tertiary care hospital in Jaipur. Indian J Pathol Microbiol 51:367–369[CrossRef]
SolomkinJ. S.,
DellingerE. P.,
ChristouN. V.,
BusuttilR. W.1990; Results of a multicenter trial comparing imipenem/cilastin to tobramycin/clindamycin for intra-abdominal infections. Ann Surg 212:581–591[CrossRef]
SolomkinJ. S.,
MazuskiJ. E.,
BradleyJ. S.,
RodvoldK. A.,
GoldsteinE. J.,
BaronE. J.,
O'NeillP. J.,
ChowA. W.,
DellingerE. P.other authors2010; 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. Clin Infect Dis 50:133–150[CrossRef]
WiltonP.,
SmithR.,
CoastJ.,
MillarM.2002; Strategies to contain the emergence of antimicrobial resistance: a systematic review of effectiveness and cost-effectiveness. J Health Serv Res Policy 7:111–117[CrossRef]
YellinA. E.,
HeseltineP. N.,
BerneT. V.1985; The role of Pseudomonas species in patients treated with ampicillin and sulbactam for gangrenous and perforated appendicitis. Surg Gynecol Obstet 161:303–307