A one-year cross sectional study of peritoneal fluid cultures and antibiotic sensitivity patterns in cases of surgical peritonitis

Nidhi Shah; Mehnish Malik; S. Deoleker; P. S. Eswar; Zulekha Bhimani

doi:10.18203/2349-2902.isj20250570

Authors

Nidhi Shah Department of General Surgery, Dr. D. Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India
Mehnish Malik Department of General Surgery, Dr. D. Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India
S. Deoleker Department of General Surgery, Dr. D. Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India
P. S. Eswar Department of General Surgery, Dr. D. Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India
Zulekha Bhimani Department of General Surgery, Dr. D. Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20250570

Keywords:

Surgical peritonitis, Peritoneal fluid cultures, Microbiology, Antimicrobial resistance, Antibiotic sensitivity

Abstract

Background: Surgical peritonitis is a serious complication with significant morbidity and mortality. Understanding the microbiological profile and antibiotic sensitivity patterns is crucial for optimal management. This study aimed to evaluate the peritoneal fluid cultures and antibiotic sensitivity patterns in cases of surgical peritonitis.

Methods: This was a hospital-based prospective study conducted at D. Y. Patil University School of Medicine, Nerul, Navi Mumbai, over a one-year period. Patients presenting with peritonitis were included, and peritoneal fluid samples were collected during surgery for microbiological analysis. Antibiotic treatment was guided by the culture and sensitivity results.

Results: A total of 50 patients were enrolled. The most common etiologies were appendicitis (32%), diverticulitis perforation (24%), and perforated duodenal/peptic ulcers (44%). The predominant pathogens isolated from peritoneal fluid cultures were E. coli (16%), Bacteroides fragilis (14%), S. aureus (14%), and Streptococcus anginosus (14%). Antibiotic sensitivity patterns revealed high susceptibility to multiple antibiotics for E. coli, Bacteroides fragilis, and Klebsiella pneumoniae. However, Enterococcus faecalis exhibited concerning resistance to vancomycin and linezolid.

Conclusions: This study provides valuable insights into the microbiology and antibiotic susceptibility profiles of pathogens involved in surgical peritonitis cases. The findings can inform empiric antimicrobial treatment strategies and guide antibiotic stewardship efforts in the management of this serious condition.

Metrics

Metrics Loading ...

References

Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012;6(2):172-87. DOI: https://doi.org/10.5009/gnl.2012.6.2.172

Lammert F, Gurusamy K, Ko CW, Miquel JF, Méndez-Sánchez N, Portincasa P, et al. Gallstones. Nat Rev Dis Primers. 2016;2:16024. DOI: https://doi.org/10.1038/nrdp.2016.24

Portincasa P, Moschetta A, Palasciano G. Cholesterol gallstone disease. Lancet. 2006;368(9531):230-9. DOI: https://doi.org/10.1016/S0140-6736(06)69044-2

Wang DQ, Cohen DE, Carey MC. Biliary lipids and cholesterol gallstone disease. J Lipid Res. 2009;50:S406-11. DOI: https://doi.org/10.1194/jlr.R800075-JLR200

Friedman GD. Natural history of asymptomatic and symptomatic gallstones. Am J Surg. 1993;165(4):399-404. DOI: https://doi.org/10.1016/S0002-9610(05)80930-4

Sharma M, Pathak A. Cholelithiasis: a review of diagnostic imaging findings and current treatment options. Clin Imaging. 2018;52:227-36.

Keus F, de Jong J, Gooszen HG, van Laarhoven CJ. Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev. 2006;(4):CD006231. DOI: https://doi.org/10.1002/14651858.CD006231

Strasberg SM. Clinical practice. Acute calculous cholecystitis. N Engl J Med. 2008;358(26):2804-11. DOI: https://doi.org/10.1056/NEJMcp0800929

Kim IS, Myung SJ, Lee SS. Classification and characterization of gallstones by infrared spectroscopy. Biopolymers. 2003;72(4):230-40. DOI: https://doi.org/10.3349/ymj.2003.44.4.561

Vítek L, Carey MC. New pathophysiological concepts underlying pathogenesis of pigment gallstones. Clin Res Hepatol Gastroenterol. 2012;36(2):122-9. DOI: https://doi.org/10.1016/j.clinre.2011.08.010

Bansal A, Akhtar MD, Bansal AK. A clinical study: prevalence and management of cholelithiasis. Int Surg J. 2014;1(3):134-9. DOI: https://doi.org/10.5455/2349-2902.isj20141105

Hussain A, Mahmood HK, Duluk K. Laparoscopic cholecystectomy can be safely performed in a resource-limited setting: the first 49 laparoscopic cholecystectomies in Yemen. JSLS. 2008;12(1):71-6.

Palanivelu C, Jani K, Maheshkumar GS. Single-center experience of laparoscopic cholecystectomy. J Laparoendosc Adv Surg Tech A. 2007;17(5):608-14. DOI: https://doi.org/10.1089/lap.2006.0192

Ganey JB, Johnson PA Jr, Prillaman PE, McSwain GR. Cholecystectomy: clinical experience with a large series. Am J Surg. 1986;151(3):352-7. DOI: https://doi.org/10.1016/0002-9610(86)90466-6

Everhart JE, Khare M, Hill M, Maurer KR, prevalence and ethnic differences ingall bladder disease in united states. Gastroenterology. 1999;117(3):632-9. DOI: https://doi.org/10.1016/S0016-5085(99)70456-7

van der Steeg HJ. Alexander S, Houterman S, Slooter GD, Roumen RM. Risk factors for conversion during laparoscopic cholecystectomy - experiences from a general teaching hospital. Scand J Surg. 2011:100(3):169-73. DOI: https://doi.org/10.1177/145749691110000306

Eldar S, Sabo E. Nash E, Abrahamson J, Matter I. Laparoscople cholecystectomy for impacted stones: prospective trial. World J Surg. 1997;21:540-5. DOI: https://doi.org/10.1007/PL00012283

Joseph K, Joel J. Cholelithiasis and cholecystectomy. In: Zinner M, editor. Maingot's abdominal operations. 10th Edition. Singapore: McGraw-Hill Companies. 2001.