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Epidemiology and Microbiology of Secondary Peritonitis Caused by Viscus Perforation: A Single-Center Retrospective
Ji Young Jang1, Seung Hwan Lee2, Hongjin Shim1
11 Department of Surgery, Yonsei University Wonju College of Medicine , Wonju, Republic of Korea.
Background:
Complicated intra-abdominal infections are serious conditions that require urgent source control and antibiotic treatment. The purpose of this study was to evaluate the epidemiology and bacterial causation of such infections using blood and peritoneal cultures of Korean patients with peritonitis originating from viscus perforation.
Methods:
The medical records of 419 consecutive patients who underwent emergency surgery because of bowel perforation from January 2007 to December 2011 were analyzed. Clinical characteristics, peri-operative conditions, perforation sites, and mortality data were obtained. Bacterial distributions and antibiotic resistance were evaluated using blood and peritoneal culture reports.
Results:
The most common perforation site was the colon (165; 39.4%), and the overall mortality rate was 11.2%. Blood cultures were performed in 182 patients, and 20 patients (11.0%) had a positive culture. Blood culture positivity was significantly higher for colon perforations (17.7%) than perforations elsewhere (p=0.039). A peritoneal culture was performed for each of 210 patients (50.1%), and 145 of those patients (69.0%) had a positive culture. Enterococcus faecium (35.2%) was the most common gram-positive bacterium, and Escherichia coli was the most common gram-negative organism. There were 276 community-acquired infections (CAI) (65.9%) and 143 hospital-acquired infections (HAI) (34.1%). Escherichia coli producing extended-spectrum β-lactamases were more common in the HAI than in the CAI group (p=0.016).
Conclusions:
The compositions and antibiotic resistances of micro-organisms found in this study are similar to those reported previously. A multicenter prospective study is needed of this disease state in South Korea.
Insights
Complicated intra-abdominal infections in Korean patients show similar microbial patterns and antibiotic resistance to previous studies. Further multicenter research is recommended for this condition.
Area of Science:
- Infectious Diseases
- Microbiology
- Surgical Infections
Background:
- Complicated intra-abdominal infections (IAIs) are critical conditions requiring immediate source control and antibiotic therapy.
- Peritonitis from viscus perforation presents a significant clinical challenge.
Purpose of the Study:
- To investigate the epidemiology and bacterial causes of IAIs in Korean patients with peritonitis due to viscus perforation.
- To analyze microbial profiles and antibiotic resistance patterns from blood and peritoneal cultures.
Main Methods:
- Retrospective analysis of 419 patients undergoing emergency surgery for bowel perforation (2007-2011).
- Collection of clinical data, perforation site, and mortality.
- Evaluation of bacterial distributions and antibiotic resistance from blood and peritoneal cultures.
Main Results:
- Colon perforation was the most frequent site (39.4%); overall mortality was 11.2%.
- Peritoneal cultures yielded positive results in 69.0% of cases, with Enterococcus faecium and Escherichia coli as predominant pathogens.
- Hospital-acquired infections showed a higher prevalence of extended-spectrum β-lactamase-producing Escherichia coli.
Conclusions:
- Microbial compositions and antibiotic resistance in Korean IAIs align with prior international findings.
- The study highlights the need for a comprehensive, multicenter prospective investigation in South Korea.
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