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DOI: 10.48087/BJMS.2026.130301
Authors: Khalida CHARAOUI1,2, Nadia BOULAKEHAL1,2, Zoheir BOUCHAIR1,3, Ali BELMIR1,3, Omar KAOUECHE1,4, Kaddour BENLABED1,4, Rafik KARA-MOSTEFA1,5, Hichem MAKHLOUFI1,5
Affiliations: 1- Faculty of Medicine, University Constantine 3, Salah Boubnider, Constantine, Algeria. 2- Infectious Diseases Department, Dr Benbadis University Hospital Center, Constantine, Algeria. 3- Department of Surgical Emergencies, Dr Benbadis University Hospital Center, Constantine, Algeria. 4- Microbiology Department, Dr Benbadis University Hospital Center, Constantine, Algeria. 5- Department of Anesthesia and Intensive Care, Dr Benbadis University Hospital Center, Constantine, Algeria
Abstract
Background: Introduction and objectives: Intra-abdominal infections are the leading non-traumatic surgical emergencies, with persistently high morbidity and mortality. The objective of our work is to report the epidemiological, clinical, diagnostic, and therapeutic aspects of complicated community-acquired intra-abdominal infections in adults. Patients and methods: A prospective, descriptive study was conducted from September 2016 to March 2018 on a cohort of adult patients who underwent surgery for community-acquired complicated intra-abdominal infections. Data were collected using survey forms. Epidemiological, clinical, biological, radiological, therapeutic, and evolutionary variables were described. Results: 227 patients were recruited. Mean age was 44 ± 20 years [range: 15 to 90 years]. The sex ratio was 1.9. Twenty-six percent of patients had at least one comorbidity. The most frequent symptoms were abdominal pain (99%), signs of peritoneal irritation (89%), clinical presentation of acute appendicitis (56%), nausea and/or vomiting (46%), and occlusive syndrome (22%). Fever was present in 45% of patients; 7% had signs of severity at admission. The source of contamination was appendicular in more than 50% of cases. Empirical antibiotic therapy consisted of cefazolin in 75% of cases; 49% received triple therapy with gentamicin and metronidazole, and 25% received dual therapy with metronidazole. Cefotaxime was prescribed in severe cases or in the presence of comorbidities. Peritoneal fluid culture was positive in 58% of cases, with Escherichia coli isolated in 51%. The mortality rate was 15.4%. Discussion and conclusion: Intra-abdominal infections were of appendicular origin in more than half of the cases in our series. Mortality was associated with advanced age, presence of comorbidities, severity of the initial clinical presentation, and colorectal origin of the infection.
Keywords: intra-abdominal infections, epidemiology, diagnosis, empirical antibiotic therapy, microbiology.