The following is a summary of the “Do Cultures From Percutaneously Drained Intra-abdominal Abscesses Change Treatment? A Retrospective Review,” published in the March 2023 issue of Hematology by Esposito, et al.

The purpose of this research was to evaluate the value of taking cultures from intra-abdominal abscesses after they have been drained percutaneously.  Patients hospitalized between 2013 and 2021 for a diverticulitis- or appendicitis-related intraabdominal abscess treated with image-guided percutaneous drain were included in the analysis, with the exclusion of those undergoing active chemotherapy, those with HIV, and those who had received a solid organ transplant. Antimicrobial treatment was adjusted based on the results of routine culture of percutaneous drains. Of those who were eligible, 221 patients were included. More than half (56%) were diagnosed with diverticulitis, whereas nearly half (44%) were treated with appendicitis.

Patients had a median age of 62 (range: 18-93), were predominantly female (54%), and 14% were current smokers. Both the average amount of time spent in the hospital and on antibiotics was 8 days (range: 1-78). (range, 1–22). Only 8% (16/211) of patients had their antibiotic regimens modified because of culture results from percutaneous drains. 95% of the drains yielded a culture, with 78% of those showing signs of growth. About 66% of cultures produced more than one bacterial species, and another 13% produced a mixture of species without speciation. One-third of all pathogens belonged to the Bacteroides family. Ceftriaxone was administered in 33% of patients and metronidazole was utilized in 40% of patients as an empiric antibiotic regimen. 

The likelihood of cultures impacting antimicrobial therapy was higher for patients of female sex (P = 0.027) and when bacteria of any antibiotic resistance were present (P < 0.01). Microscopic community analysis, performed retroactively and confined to a particular location. Antimicrobial therapy was modified for only 8% of patients based on microbiology data from image-guided percutaneous drains of abdominal abscesses, which is less than what has been reported in the published literature for cultures collected surgically. Culturing material from drains inserted in abdominal abscesses routinely is not suggested due to the low success rate (same as with cultures acquired intraoperatively).

Source: journals.lww.com/dcrjournal/Abstract/2023/03000/Do_Cultures_From_Percutaneously_Drained.18.aspx