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Bacteriological study of 28 patients with intraabdominal infection in Japan
1Department of Internal Medicine, Gifu Red Cross Hospital, 3-36 Iwakura-cho, Gifu 502-8511, Japan.
Abstract:
Intraabdominal infections are usually polymicrobial, including both aerobes and anaerobes. To assess the importance of anaerobes in intraabdominal infection, a bacteriological study was performed. The subjects studied were 28 inpatients with acute abdomen who visited Gifu Red Cross Hospital, Gifu, Japan, between May 1996 and July 1998. Twenty-one patients had abscess or peritonitis caused by perforation of the gastrointestinal tract, 4 had liver abscess, 2 had pelvic abscess, and 1 had retroperitoneal and subcutaneous abscess. Most specimens were cultured within 6 h after sampling. Using the E test, we tested the susceptibilities of isolates to 11 antimicrobial agents. Anaerobes were predominantly recovered from intraabdominal infection caused by perforation of the small bowel, appendix, and large bowel. The anaerobes isolated were resistant to the cephems tested, to which the aerobic strains were susceptible. It is suggested that carbapenems may be the choice for treatment of severe intraabdominal infection, especially that resulting from perforation of the small bowel, appendix, and large bowel.
Insights
Anaerobes play a significant role in intraabdominal infections, particularly those from gastrointestinal perforations. Carbapenems show promise for treating severe cases involving anaerobic bacteria.
Area of Science:
- Infectious Diseases
- Microbiology
- Surgical Infections
Background:
- Intraabdominal infections are complex, often involving a mix of aerobic and anaerobic bacteria.
- Understanding the specific role of anaerobic pathogens is crucial for effective treatment strategies.
Purpose of the Study:
- To evaluate the prevalence and significance of anaerobic bacteria in intraabdominal infections.
- To assess antimicrobial susceptibility patterns of isolated aerobic and anaerobic bacteria.
Main Methods:
- Bacteriological study of 28 inpatients with acute abdomen between May 1996 and July 1998.
- Specimen cultures performed within 6 hours of sampling.
- Antimicrobial susceptibility testing using the E test against 11 agents.
Main Results:
- Anaerobes were frequently isolated from infections secondary to gastrointestinal tract perforations (small bowel, appendix, large bowel).
- Isolated anaerobes exhibited resistance to tested cephem antibiotics, while aerobic strains remained susceptible.
- Specific infection types included perforation-related abscess/peritonitis, liver abscess, and pelvic abscess.
Conclusions:
- Anaerobic bacteria are key players in intraabdominal infections, especially those originating from bowel perforations.
- Carbapenems are suggested as a potential first-line treatment for severe intraabdominal infections, particularly those involving the small bowel, appendix, and large bowel.