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[Bacteria isolated from intraabdominal infection and their susceptibilities to antimicrobial agents]
N Shinagawa1, A Mizuno, K Mashita
1First Department of Surgery, Nagoya City University Medical School.
Abstract:
Bacteria isolated from intraabdominal infections during the period from July 1982 to June 1993 were investigated with regard to their classifications according to a joint research by 9 university hospitals in Japan. The following results were obtained. 1. A total of 971 strains were isolated from 684 out of 597 patients with peritonitis, and 287 strains out of 971 were isolated from postoperative peritonitis. 2. The most predominant organism isolated from patients with acute peritonitis was Escherichia coli (28%), followed by Bacteroides fragilis group (17%), Gram-positive anaerobic cocci (16%), Enterococcus spp. (9%) and Klebsiella spp. (8%). 3. Against E. coli, cefmenoxime, cefuzonam, cefozopran, aztreonam and carumonam showed MIC50 less than 0.05 micrograms/ml. Against B. fragilis group, erthromycin, clindamycin, imipenem, lincomycin and latamoxef showed MIC50 less than 0.78 micrograms/ml. 4. The most predominant organism isolated from patients with postoperative peritonitis was Enterococcus spp. (20%) and followed by Pseudomonas spp. (14%), and Staphylococcus spp. (13%), E. coli (9%), Enterobacter spp. (8%) and Klebsiella spp. (8%). We suggest that cefazolin, cefmetazole, flomoxef, cefmenoxime, cefuzonam, and latamoxef are the first choice agents in empiric therapy for the treatment of acute peritonitis.
Insights
This study analyzed bacteria from intraabdominal infections in Japan, finding Escherichia coli and Bacteroides fragilis group predominant in acute peritonitis. Empiric antibiotic therapy recommendations were provided for effective treatment.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Pharmacology
Context:
- Intraabdominal infections represent a significant clinical challenge, often polymicrobial.
- Understanding bacterial prevalence is crucial for effective empiric antibiotic selection.
- This research involved a decade-long surveillance across nine Japanese university hospitals.
Purpose:
- To classify bacterial isolates from intraabdominal infections.
- To determine the most prevalent bacterial pathogens in acute and postoperative peritonitis.
- To evaluate the in vitro susceptibility of key pathogens to various antibiotics.
Summary:
- A total of 971 bacterial strains were isolated from 597 patients with peritonitis.
- Escherichia coli and Bacteroides fragilis group were the most common in acute peritonitis, while Enterococcus spp. predominated in postoperative peritonitis.
- Specific antibiotics demonstrated high in vitro activity against the predominant pathogens, informing treatment guidelines.
Impact:
- Provides critical data on bacterial epidemiology in Japanese intraabdominal infections.
- Informs evidence-based empiric antibiotic therapy choices for peritonitis.
- Contributes to antimicrobial stewardship by highlighting effective agents against common pathogens.