腹膜炎急诊剖腹手术患者的微生物特征及抗生素敏感性

V. Jayaprakash, Poorvi Sharma, R. Shenoy, S. KRISHNA M
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引用次数: 0

摘要

腹膜炎是常见的急症之一,其发病机制涉及多种生物。抗生素的不适当和长期使用被归因于抗生素耐药性的出现。这是一项回顾性观察性研究,从2018年1月1日到2019年12月31日(两年)。本研究纳入了接受手术的继发性腹膜炎患者。研究了腹膜液、血液和手术部位常见致病菌及其对抗生素的敏感性。穿孔性腹膜炎是腹膜炎最常见的病因。头孢哌酮舒巴坦和哌拉西林他唑巴坦是常用的经验性抗生素。从腹膜液中分离出的最常见的微生物是大肠杆菌,其次是肺炎克雷伯菌,并发现其对常用抗生素具有足够的敏感性。在血液培养中分离出的常见菌种为肠球菌和念珠菌。伤口拭子中的大肠杆菌和克雷伯菌对经验性抗生素表现出较高的耐药性。大肠穿孔的手术部位感染率较高。大肠杆菌和肺炎克雷伯菌是继发性腹膜炎的常见病因。实验证明,该抗生素对腹膜腔分离的常见生物体敏感。伤口拭子分离物对抗生素表现出更高的耐药性,因此分离生物体并评估其敏感性可能是谨慎的。由于微生物对抗生素耐药性趋势的地理差异,谨慎的做法是在当地进行抗生素监测,以推荐合适的抗生素。
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PROFILE OF MICROORGANISM AND ANTIBIOTIC SENSITIVITY PATTERN IN PATIENTS UNDERGOING EMERGENCY LAPAROTOMY FOR PERITONITIS
Peritonitis is one of the common emergencies and multiple organisms have been implicated in the pathogenesis. Inappropriate and prolonged use of antibiotics have been attributed to the emergence of antibiotic resistance. This is a retrospective observational study, from 1st January 2018 to 31st December 2019 (Two years). Patients with secondary peritonitis undergoing surgery are included in this study. Common pathogens and its antibiotic sen sitivity pattern from peritoneal fluid, blood and surgical site were studied. Perforation peritonitis is the most common cause of peritonitis. Cefaperazone-sulbactum and Piperacillin-tazobac tum were the common empirical antibiotics prescribed. Escherichia coli followed by Klebsiella pneumonia were the commonest microorganism isolated from the peritoneal fluid and found to have adequate sensitivity for the empiri cal antibiotics. Enterococus and candida were the common organism isolated in blood culture. E-coli and Klebsiella from wound swab showed higher resistance to the empirical antibiotics. Large intestine perforation has higher percentage of surgical site infection. E-coli and Klebsiella pneumoniae were the common cause of secondary peritonitis. The empirical antibiotic is shown to be sensitive to the common organism isolated from peritoneal cavity. Wound swab isolates have shown higher resistance to antibiotics hence isolating the organism and assessing the sensitivity might be prudent. Due to geographical variation of antibiotic resistance trends to microorganism, it is prudent to have antibiotic surveillance on a local basis that can recommend appropriate antibiotics.
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