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Session:: ePosters-Sun800-M7: Benign Anorectal

EP319 - The Microbiological Profile of Cryptoglandular Anorectal Abscess in Diabetes Mellitus: A Comparative Study

Sunday, May 10, 2026
9:49 AM - 9:54 AM ET

    ePoster Presenter(s)

  • NA

    Najeeba SMJA Alsabagha, MD

    Resident
    Kuwait board of general surgery
    Kuwait Board of General Surgery
    Kuwait, Hawalli, Kuwait

    Disclosure information not submitted.

    View ePoster

    • Author(s)

  • Abdulmohsen Makhsaid

    Assistant Registrar
    Department of General Surgery, Mubarak Al-kabeer Hospital
    Sabah Alsalem, Mubarak al Kabir, Kuwait

    All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

  • Hasan F. Shehab, Jr. (he/him/his)

    Assistant Registrar
    Mubarak Al-Kabeer Hospital
    Kuwait, Hawalli, Kuwait

    Disclosure information not submitted.

  • AK

    Abdulaziz Ali Karam, MD, MB BCh BAO, DABS, FRCSC

    Assistant Professor - General surgery department
    Kuwait University
    Kuwait, Mubarak al Kabir, Kuwait

    Disclosure information not submitted.

  • FA

    Fawaz Alnaqi, MD MPH FRCSC FACS

    Assistant Professor
    College of Medicine, Kuwait University
    Kuwait city, Al Asimah, Kuwait

    Disclosure information not submitted.

    • Senior Author(s)

  • JA

    Jasim Alabbad, MD FRCSC FACS FASCRS

    Associate Professor
    Kuwait University
    Jabriya, Hawalli, Kuwait

    Disclosure information not submitted.

Purpose/Background: Anorectal abscesses are common surgical emergencies with a variable microbiological profile. Guidelines recommend antibiotics for patients with underlying immunosuppression including diabetes mellitus (DM), yet there is a paucity of evidence regarding the microbial spectrum in DM. This study compares cultures from anorectal abscess in patients with DM to those without DM, to inform targeted antibiotic therapy.

Methods/Interventions: Following institutional review board approval, a retrospective study was conducted involving all patients (age ≥ 18) who had intraoperative cultures following incision and drainage (I&D) of anorectal abscess in the operating room between June 2010 and December 2024 in a single academic institution in Kuwait. Patients < 18 years, those with necrotizing soft tissue infection, a concurrent fistula-in-ano at surgery, those with no microbiological cultures and patients with a history of inflammatory bowel disease were excluded. Patients were grouped into patients with DM and non-DM. Demographic, clinical, and perioperative characteristics were analyzed and compared between the two groups. The primary outcome was to compare the microbiological profiles between groups.

Results/Outcomes: A total of 408 patients underwent I&D with cultures obtained. There were 96 (23.5%) patients that had diabetes mellitus. The overall median age was 44.0 years (35.3-54.0), with 78.7% being male. Table 1 compares the perioperative characteristics and organism profiles between the two groups. There were no differences in demographics between patients with DM and non-DM. However, patients with DM had significantly higher rates of smoking (26.9% vs 13.2%, p=0.008) and cellulitis (60.4% vs 38.5%, p< 0.001). Abscess location did not differ significantly between the groups. Microbiological analysis revealed increased isolation of klebsiella pneumoniae (26.0% vs 15.1%, p=0.021), streptococcus spp. (25.0% vs 10.9%, p=0.001), and Methicillin-Resistant Staphylococcus aureus (8.3% vs 3.2%, p=0.045) in patients with DM. Conversely, Escherichia coli and Bacteroides spp. were less prevalent, and no difference in extended‐spectrum β-lactamase producers was observed in either group (14.7% vs 9.4%, p=0.231).

Conclusion/Discussion: DM appears to be associated with a distinct microbiological profile and these findings may inform tailored antimicrobial strategies.

comparison of characteristics and microbiological profile of anorectal abscess in patients with diabetes mellitus and those without