Bacterial Pathogens, Drug-Resistance Profile and Its Associated Factors from Patients with Suspected Peritonitis in...

Ascitic fluid plays a critical role in the microbiological diagnosis of peritonitis. Drug-resistant bacterial infection of the peritoneal cavity is becoming a public health threat. However, data on bacterial profile and antimicrobial-resistant pattern of isolates from the ascitic fluid are scarce. Thus, this study was aimed to assess drug-resistant bacteriological profiles and factors associated with peritonitis in southern Ethiopia.

An institutional-based cross-sectional study was conducted from March 2019 to December 2019. A semi-structured questionnaire was used to collect socio-demographic and clinical data. A total of 147 ascitic fluid samples were aseptically collected and inoculated onto blood agar, MacConkey agar, and chocolate agar. The inoculated culture media were incubated aerobically and micro-aerobically at 37°C for 48 hrs. Bacterial identification was done by standard protocols and the antimicrobial susceptibility testing by Kirby Bauer's disk diffusion method. Logistic regression was used to identify the associated factors with bacterial peritonitis.

Of the total study participants, the overall magnitude of bacterial peritonitis was 19.05% with a total of 30 bacterial isolates. Majority of the isolates were Gram negative bacteria with predominant species E. coli 36.67% followed by Gram positive S. aureus 13.33%. The multidrug resistant isolates accounts about 43.3% while a quarter of isolated S. aureus were methicillin resistant. The bacterial peritonitis was associated with recent history of surgery [AOR = 8.724, 95% CI: (2.688-28.314)], hospitalization more than seven days [AOR = 8.990, 95% CI: (2.755-29.342)], cirrhosis [AOR = 2.751, 95% CI: (1.109-6.822)] and alcoholism [AOR = 5.802, 95% CI: (1.948-17.285)].

Nearly half of the isolated bacteria were observed to be MDR, and this may alarm all healthcare workers and policymakers. Thus, continuous surveillance of antimicrobial resistance patterns along with associated factors is essential for regular monitoring of transmission of drug-resistant bacteria and the emergence of antibiotic resistance.