Résumé
Community-acquired intra-abdominal infections (CA-IAIs) is a common condition associated with significant morbidity and mortality. Appropriate antibiotic therapy guided by microbiological documentation is crucial for optimal management. This study aimed to describe the microbiological profiles of CA-IAIs according to the appendicular or non-appendicular source of infection and evaluate adherence to French recommendations. Methods: this retrospective study analyzed data from the PERICOM database, a multicenter prospective observational study conducted in 13 French hospitals. The study included patients diagnosed with CA-IAIs. Microbiological documentation, antibiotic appropriateness, and adherence to recommendations of the Société Française d’Anesthésie et de Reanimation (SFAR) regarding antibiotic therapy were assessed. Results: a total of 205 patients with CA-IAI were included in the analysis. Microbiological samples had been performed in 178 patients (87%), with successful microbiological documentation achieved in 127 patients (62%) with 52 (41%) patients presenting documented appendicular CAIAIs and 75 (59%) patients presenting documented non appendicular CA-IAIs. The microbiological documentation revealed the presence of gram-negative bacilli (GNB) in 88% of appendicular CA-IAIs and 82% of non-appendicular CA-IAIs (p=0.52), non-fermenting GNB in 26% and 10% (p=0.046), gram-positive cocci in 34% and 49% (p=0.044), and anaerobes in 52% and 2% (p=0.008) of cases. Empirical antibiotic therapies were in accordance with SFAR recommendations in 99/205 (48%) of patients. The most frequently initiated empirical antibiotic therapy was a combination of third-generation cephalosporin and metronidazole (34%) regardless of the severity. The rate of adequacy of antibiotic therapy to microbiological results was not significantly different between patients treated according to recommendations and those treated otherwise (81% vs 73%; p=0.44). Conclusion: this analysis provides insights into the different microbiological profiles of CA-IAIs comparing appendicular and non-appendicular localization, and highlights the suboptimal adherence to French recommendations regarding antibiotic therapy. Further studies are warranted to explore the reasons behind the observed non-adherence.