BACTERIOLOGY OF ACUTE PERITONITIS

Abstract

We performed a bacteriological examination on 183 patients with acute peritonitis in six university hospitals between 1982 and 1986. Bacteria were isolated from 138 (75.4%) of these patients. There were 47 strains of aerobic Gram-positive cocci, 129 of aerobic Gram-negative rods, 50 of anaerobic Gram-positive bacteria and 52 of anaerobic Gram-negative bacteria. The most frequent isolate was Escherichia coli, followed by the Bacteroides fragilis group, Peptostreptococcus spp., Klebsiella spp., Enterococcus spp., anerobic streptococci, Enterobacter spp. and Pseudomonas aeruginosa, in that order. The MIC₈₀ of cefotaxime against E. coli was lowest, followed by ceftizoxime, cefmenoxime and cefotiam, in that order. Against the B. fragilis group, the MIC₈₀ of latamoxef was lowest, followed by cefmetazole, piperacillin, cefotaxime, ceftizoxime and cefmenoxime. Against E. faecalis, the MIC₈₀ of piperacillin was 3.13μg/ml, being the lowest, while the other drugs showed MIC80 values higher than 12.5μg/ml. The susceptibility of Klebsiella spp. was similar to that of E. coli. Against Peptostreptococcus spp., the MIC₈₀ of cefalothin was lowest, followed by cefazolin, piperacillin, ceftizoxime, cefmenoxime and cefotaxime. Against P. aeruginosa, the MIC₈₀ of gentamicin was lowest, followed by amikacin, piperacillin and cefoperazone. Taking the viability of the bacteria into account, cefotaxime, ceftizoxime, cefmenoxime, and cefotiam of the cephems, and piperacillin of the penicillins, are indicated for the treatment of acute peritonitis.