Research Day
TO CULTURE OR NOT TO CULTURE: DOES MICROBIOLOGY AFFECT MORTALITY AFTER INTRA-ABDOMINAL INFECTION?
Document Type
Abstract
Date
2021
Abstract
Intra-abdominal infections (IAI) require both antibiotic therapy and source control for adequate treatment. Culture obtained at timing of source control can help to direct antimicrobial therapy. We hypothesize that availability of cultures for the management of IAI is associated with lower mortality. All IAI treated between 1997 and 2017 at a single institution were stratified by whether or not cultures were obtained during operation or drainage procedure. Demographics and in-hospital mortality were compared by Student's t test and Chi-Square analysis, predictors of mortality by logistic regression (LR) analysis. A total of 2963 IAIs were treated, 1062 (35.8%) without culture and 1901 (64.2%) with cultures. The patients without culture had a significantly lower average APACHE II score (11.0 ± 0.2) compared to the culture group (13.4 ± 0.2) (p <0.0001). The no culture group also had a significantly lower percentage of healthcare associated infections compared to the culture group (51.4% versus 70.4%, p < 0.0001). Independent predictors of mortality included age, APACHE II score, and history of prior cellular transfusion during hospitalization, but not the availability of cultures (p = 0.26). The no culture group had a significantly lower duration of antimicrobial therapy than the culture group (10.2 ± 0.3 days versus 13.9 ± 0.3 days, p < 0.0001). In this study, we found no evidence that obtaining cultures improved survival following the treatment of IAI. These findings suggest that the practice of culturing IAI should be abandoned and further highlight the importance of source control for determining outcomes.