Comparison of Microbiological Profile of Drained Intra-Abdominal Abscess in Patients with Crohn’s Disease and Colonic Diverticulitis

Abstract

Aim: To investigate the microbiological profile of intra-abdominal abscesses drained from patients with Crohn’s disease (CD) compared to patients with complicated diverticulitis coli (cDC). Method: This was a retrospective, cohort, pilot study. Inclusion criteria were adult patients who underwent percutaneous ultrasonographic/computed tomography (CT) guided drainage or aspiration of abscess. Cultures were performed for all patients and tested with Gram staining. Demographic data, pre-operative medications taken for CD, abscess size, antibiotic coverage after drainage, abscess recurrence, surgical resection, resection type and post-operative complications were investigated. Results: A total 44 patients with CD (n=18) and cDC (n=26) were investigated in this pilot study. Cultures showed mostly mixed Gram-positive and negative bacteria in both CD and cDC, but Gram-negative culture was more prevalent in cDC (p=0.029). The most common bacteria was Escherichia coli in both groups. Anaerobic bacteria were the second most common flora in patients with cDC, while Streptococcus , Enterococcus , Extended spectrum Beta Lactamase-producing organisms, Pseudomonas , Morganella and Proteus were the second most common in patients with CD. Conclusion: Mixed Gram-positive and negative bacteria with Escherichia coli were the most common bacteria in CD and cDC. Both groups also showed significant growth of Enterococci , Streptococci , and anaerobic bacteria in culture. Klebsiella pneumoniae was significantly more prevalent in patients with CD.