PDF(Pubmed)
Abstract：
Introduction One of the most frequent emergencies that a general surgeon deals with is perforation peritonitis. The anatomical site of the perforation, which in turn affects the source of infection, has a major impact on the mortality rate due to perforation peritonitis. Early and suitable antibiotic therapy can be started in the postoperative period with the aid of knowledge about the microbiological profile and sensitivity of peritoneal fluid culture with respect to the anatomical sites of perforation peritonitis. Methods A cross-sectional study was conducted from June 2021 to November 2021 where peritoneal fluid samples were collected intraoperatively from patients with perforation peritonitis. This was subjected to culture and sensitivity, and results were analyzed with respect to anatomical sites of perforation. Results Forty cases were investigated. The ileum (30%) was the most common site of perforation, followed by the stomach (22.5%), appendix (20%), duodenum (12.5%), caecum (5%), jejunum (5%), transverse colon (2.5%), and rectum (2.5%). Escherichia coli (E. coli) and Klebsiella spp. were the most frequently found organisms in all sites of perforation peritonitis. The most sensitive antibiotics covering all isolated organisms were amikacin and meropenem. Sensitivity to amikacin was found in 85.18% of cases of E. coli and 84.6% of cases of Klebsiella. Sensitivity to meropenem was found in 76.9% of cases of E. coli and 80% of cases of Klebsiella. Conclusion In patients with perforation peritonitis, the peritoneal fluid cultures did not reflect the major differential normal flora according to the region of the gastrointestinal tract. The most prevalent organism isolated among all the sites of perforation peritonitis was E. coli. Antimicrobial activity against organisms isolated from perforation peritonitis patients was significantly demonstrated by aminoglycosides, piperacillin and tazobactam, and meropenem and colistin, with considerable resistance to third-generation cephalosporins.
摘要：
简介普通外科医师处理的最常见的紧急情况之一是穿孔性腹膜炎。穿孔的解剖部位，进而影响感染源，对穿孔性腹膜炎的死亡率有重大影响。早期和合适的抗生素治疗可以在术后期间开始，借助有关腹膜液培养物相对于穿孔腹膜炎解剖部位的微生物学特征和敏感性的知识。方法2021年6月至2021年11月进行了一项横断面研究，术中收集穿孔性腹膜炎患者的腹膜液样本。这受到文化和敏感性的影响，并对穿孔解剖部位的结果进行了分析。结果共调查40例。回肠（30%）是最常见的穿孔部位，其次是胃(22.5%)，附录（20%），十二指肠（12.5%），盲肠（5%），空肠（5%），横结肠（2.5%），直肠（2.5%）。大肠杆菌(E.大肠杆菌）和克雷伯菌属。是所有穿孔性腹膜炎部位最常见的生物。覆盖所有分离生物的最敏感的抗生素是阿米卡星和美罗培南。85.18%的大肠杆菌和84.6%的克雷伯菌对阿米卡星敏感。76.9%的大肠杆菌和80%的克雷伯菌对美罗培南敏感。结论在穿孔性腹膜炎患者中,根据胃肠道区域，腹膜液培养物没有反映出主要的差异正常菌群。在穿孔性腹膜炎的所有部位中分离出的最普遍的生物是大肠杆菌。氨基糖苷类对从穿孔性腹膜炎患者中分离出的生物体具有抗菌活性，哌拉西林和他唑巴坦,美罗培南和粘菌素，对第三代头孢菌素有相当大的耐药性。
