The Microbiology of Postoperative Peritonitis

Abstract

Postoperative peritonitis carries a higher risk of complications and mortality than does community-acquired disease. Little, however, is known about the specific microbiology of this condition. To gain insight into this problem, the microbiological findings of 67 patients with postoperative peritonitis were compared with those of 68 patients with community-acquired peritonitis. In a comparison of postoperative peritonitis with community-acquired disease, the number of isolates of enterococci (23 versus 6) and Enterobacter species (13 versus 4) were increased and the number of isolates of Escherichia coli (21 versus 42) were reduced. Antibiotic therapy before reintervention increased the number of resistant organisms at relaparotomy (33% versus 8%). The in vitro efficacy of the primary antibiotic or combination of drugs did not affect mortality rates (40% versus 38% after effective and ineffective treatment, respectively). Thus, the microbiology of postoperative peritonitis differs significantly from that of community-acquired disease, and specific antibiotic therapy is required, despite the doubtful impact on survival.

Prospective, Non-Interventional, Multi-Centre Trial of Tigecycline in the Treatment of Severely Ill Patients with Complicated Infections – New Insights into Clinical Results and Treatment Practice

“…Today, an involvement of drug-resistant or difficult-to-treat bacteria is not uncommon in patients with post-operative or tertiary peritonitis or necrotizing pancreatitis, pre-treated with antibiotic [26,27,28]. The results of this non-interventional study, with the largest number of patients with pre-treated cIAI as yet, are in line with this trend.…”

Landscape of Resistance-Nodulation-Cell Division (RND)-Type Efflux Pumps in Enterobacter cloacae Complex

“…E. cloacae has taken on clinical importance during the last decade and has emerged as a redoubtable pathogen, accounting for up to 5% of hospital-acquired bacteremia, 5% of nosocomial pneumonia, 4% of nosocomial urinary tract infections, and 10% of postsurgical peritonitis cases (17,18). ECC species are well adapted to the hospital environment and are able to develop MDR with very few therapeutic options.…”

Population Genetics of the Nomenspecies Enterobacter cloacae

“…Three clusters represented 70% of strains, but none of them included a type or reference strain. The genetic clustering presented in this study might serve as a framework for future studies dealing with taxonomic, evolutionary, epidemiological, or pathogenetic characteristics of bacteria belonging to the E. cloacae complex.Enterobacter cloacae has become increasingly important as a nosocomial pathogen, accounting for up to 5% of hospitalacquired septicemias, 5% of nosocomial pneumonias, 4% of nosocomial urinary tract infections, and 10% of postsurgical peritonitis cases (18,35,39). Besides its clinical significance, E. cloacae plays an important role as a pathogen in plants (2, 34) and insects (15) and is ubiquitous in the terrestrial and aquatic environments (22).…”

“…Enterobacter cloacae has become increasingly important as a nosocomial pathogen, accounting for up to 5% of hospitalacquired septicemias, 5% of nosocomial pneumonias, 4% of nosocomial urinary tract infections, and 10% of postsurgical peritonitis cases (18,35,39). Besides its clinical significance, E. cloacae plays an important role as a pathogen in plants (2,34) and insects (15) and is ubiquitous in the terrestrial and aquatic environments (22).…”