Erregerhäufigkeit und Resistenzsituation bei Peritonitis 1996

Abstract

Severe intra-abdominal infection is associated with a high mortality rate. In addition to risk factors in the patients, the causal pathogens and the selection of appropriate therapeutic procedures play an essential part in the course of these conditions. In the majority of intra-abdominal infections mixed aerobic/anaerobic infections, mostly with some involvement of enterobacteria and also of enterococci and staphylococci can be demonstrated. In addition to surgical intervention a calculated antimicrobial initial treatment of intra-abdominal infections with an antibiotic with an adequate effect to combat the pathogen concerned can contribute to improving the patient's prognosis. A calculated antibiotic treatment can only be effectively and reliably carried through if the frequency of the pathogen and the resistance situation are known. Retrospective evaluations of data on the sensitivity and frequency of pathogens from a defined group of subjects allow conclusions on the epidemiological situation in a particular catchment area or in a medical sector and thus make it possible to calculate the appropriate therapy for infections. In 1996 a total of 2,779 bacterial isolates from the intra-abdominal infection sector were examined: 935 Enterobacteriaceae, 83 nonfermenters, 177 Staphylococcus spp., 211 Enterococcus spp., 39 Streptococcus spp., and 1334 different anaerobic bacteria. Fresh clinical isolates were available for all pathogens tested. The most frequent gram-negative pathogen was E. coli (60%) and the most frequent gram-positive pathogen, E. faecalis (44%); the most frequent anaerobic pathogen was B. fragilis (39%). Taurolodine had the lowest resistance rate against gram-negative and anaerobic pathogens. Teicoplanin had the highest activity against gram-positive pathogens.

Coverage of Enterococci in Community Acquired Secondary Peritonitis: Results of a Randomized Trial

“…No confounding variables were discovered with regard to the characteristics of the peritonitis, the operative procedure applied, and the intraoperative microbiologic findings, which represent the typical flora of secondary peritonitis [45]. The fact that bacteria could be cultured at all in only 60% of the patients can be explained by the relatively high number of gastric perforations in which bacteria are not often cultured when patients are operated on early enough.…”

Chirurgisches Management der schweren Peritonitis

“…Ist die Peritonitis weniger ausgeprägt und der Verlauf unkompliziert, ist ein primärer Verschluss des Abdomens gerechtfertigt [1,13]. Bei der Mehrzahl intraabdomineller Infektionen lassen sich aerob/anaerobe Mischinfektionen am häufigsten unter Beteiligung von Enterobakterien, aber auch Enterokokken und Staphylokokken nachweisen [17]. Der Vergleich von Peritonitiskollektiven ist schwierig und muss unbedingt auf Scoresystemen beruhen [22,23] Mannheimer Peritonitis Index (MPI) als Staging-System verwendet.…”

Bacteria and Granulation Tissue Associated With Montgomery T‐Tubes

“…The results presented in the current study, as well as and by other authors, 4,15 demonstrate that S aureus and P aeruginosa were the organisms most commonly occurring at all four stent segments and near the stoma. These two organisms were even the most common ones in the tracheal secretion during nosocomial infections in 1997, 16 but airway colonization after airway stenting is never associated with signs of infection. 15 …”