Abstract:Objective: To investigate the distribution of pathogens isolated from patients with intra-abdominal infection after hepatectomy and their antimicrobial resistances as well as the relations of the clinicopathologic profiles of the patients with the type of infection. Methods: The clinical data and microbiological profiles of 95 patients with intra-abdominal infection after hepatectomy from January 2013 to December 2017 were retrospectively analyzed. The relationship between the clinical data of the patients and types of infections were determined by univariate and multivariate Logistic regression analyses. Results: Of the 95 patients, a total of 170 non-duplicate bacterial strains were isolated from culture media, 55 cases (57.9%) had single infection and 40 cases (42.1%) had mixed infection, including 80 Gram-negative bacteria (47.1%), 83 Gram-positive bacteria (48.8%) and 7 fungi (4.1%). The top five common pathogens isolated were Escherichia coli (15.3%), Enterococcus faecium (14.7%), Klebsiella pneumonia (12.4%), Enterococcus faecalis (11.2%), and Coagulase-negative staphylococci (8.2%), respectively. Antimicrobial susceptibility testing showed that the detection rate of extended-spectrum β-lactamases (ESBLs) in Escherichia coli and Klebsiella pneumonia was 76.9% and 37.5%, respectively. The susceptible rate of Escherichia coli and Klebsiella pneumonia to cefperazone-sulbactam was 66.7% and 70.0%, and to imipeniem was 100.0% and 79.2%, respectively. The susceptible rate of Acinetobacter baumannii to major antibiotics was lower than 30% except tigecycline (susceptible rate 100%). No resistance to vancomycin was found in the 44 isolates of Enterococcus faecium/faecalis, and their susceptible rate to vancomycin was 92.0% and 89.5%, respectively. All the 14 isolates of coagulase-negative staphylococci were methicillin-resistant coagulase-negative staphylococci and their susceptible rates to vancomycin and linezolid were maintained at 100%. Logistic regression analysis results showed that occurrence of postoperative intraperitoneal complications was an independent risk factor for mixed infection (P=0.006). Conclusion: Gram-positive bacteria, especially the Enterococcus species are dominant pathogens associated with intra-abdominal infection after hepatectomy. Of gram-negative bacteria, the proportion of Carbapenem-resistant Enterobacteriaceae shows an increasing trend with severe multidrug resistance problems. Occurrence of postoperative intraperitoneal complications is an independent risk factor for mixed infection.