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[1996 pathogen incidence and resistance status in peritonitis]
Abstract:
Severe intra-abdominal infection is associated with a high mortality rate. In addition to risk factors in the patients, the causal pathogens and the selection of appropriate therapeutic procedures play an essential part in the course of these conditions. In the majority of intra-abdominal infections mixed aerobic/anaerobic infections, mostly with some involvement of enterobacteria and also of enterococci and staphylococci can be demonstrated. In addition to surgical intervention a calculated antimicrobial initial treatment of intra-abdominal infections with an antibiotic with an adequate effect to combat the pathogen concerned can contribute to improving the patient's prognosis. A calculated antibiotic treatment can only be effectively and reliably carried through if the frequency of the pathogen and the resistance situation are known. Retrospective evaluations of data on the sensitivity and frequency of pathogens from a defined group of subjects allow conclusions on the epidemiological situation in a particular catchment area or in a medical sector and thus make it possible to calculate the appropriate therapy for infections. In 1996 a total of 2,779 bacterial isolates from the intra-abdominal infection sector were examined: 935 Enterobacteriaceae, 83 nonfermenters, 177 Staphylococcus spp., 211 Enterococcus spp., 39 Streptococcus spp., and 1334 different anaerobic bacteria. Fresh clinical isolates were available for all pathogens tested. The most frequent gram-negative pathogen was E. coli (60%) and the most frequent gram-positive pathogen, E. faecalis (44%); the most frequent anaerobic pathogen was B. fragilis (39%). Taurolodine had the lowest resistance rate against gram-negative and anaerobic pathogens. Teicoplanin had the highest activity against gram-positive pathogens.
Insights
Understanding pathogen frequency and resistance is crucial for treating severe intra-abdominal infections. This study identified common bacteria and antibiotic resistance patterns to guide effective antimicrobial therapy.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Pharmacology
Context:
- Severe intra-abdominal infections (IAIs) present significant mortality risks.
- Mixed aerobic and anaerobic bacterial infections are common in IAIs.
- Patient risk factors, pathogen identification, and therapeutic strategies are critical.
Purpose:
- To analyze the frequency and antimicrobial resistance patterns of pathogens causing IAIs.
- To provide data supporting calculated antimicrobial initial treatment strategies.
- To inform epidemiological understanding of IAIs in a specific region.
Summary:
- A 1996 study examined 2,779 bacterial isolates from IAIs.
- Key pathogens included Escherichia coli (60%), Enterococcus faecalis (44%), and Bacteroides fragilis (39%).
- Taurolidine showed low resistance against gram-negative and anaerobic pathogens, while teicoplanin was highly active against gram-positive pathogens.
Impact:
- Findings aid in selecting appropriate empirical antibiotic therapy for IAIs.
- Data supports informed clinical decisions for managing complex infections.
- Highlights the importance of local resistance surveillance for effective treatment.