Microbiological analysis of peritoneal fluid samples from patients with perforated peptic ulcer – retrospective observational study
Authors:
J. Ulrych 1; V. Adámková 2; M. Hostačná 1
Authors‘ workplace:
I. chirurgická klinika – hrudní, břišní a úrazové chirurgie, Všeobecná fakultní nemocnice a 1. lékařská fakulta Univerzity Karlovy v Praze
1; Klinická mikrobiologie a ATB centrum, Ústav lékařské biochemie a laboratorní diagnostiky, Všeobecná fakultní nemocnice, Praha
2
Published in:
Rozhl. Chir., 2022, roč. 101, č. 7, s. 312-317.
Category:
Original articles
doi:
https://doi.org/10.33699/PIS.2022.101.7.312–317
Overview
Introduction: Peritonitis due to perforated peptic ulcer (PPU) is a surgical emergency associated with high mortality. Preoperative management includes immediate initiation of broad-spectrum antimicrobial therapy. The objective of this study was to assess the spectrum of microbial pathogens in peritoneal fluid.
Methods: Retrospective observational study of patients who underwent surgery for PPU at the 1st Department of Surgery – Thoracic, Abdominal and Injury Surgery, General University Hospital in the period 2015–2020. Analysis of the microbiological analytical results of peritoneal fluid.
Results: The microbiological profile of PPU-associated peritonitis is somewhat different from microbial pathogens involved in secondary peritonitis due to bowel perforation. A high rate of negative culture findings, high incidence of Candida spp. and low incidence of anaerobic bacteria are characteristic for PPU-associated peritonitis. Negative culture from the peritoneal fluid collected during surgery was identified in 42% of the patients. A total of 66 isolates of microbial pathogens were identified, including Candida spp. (42.5%), aerobic gram-positive bacteria (30.3%), aerobic gram-negative bacteria (22.7%) and anaerobic bacteria (4.5%). Candida albicans and Candida glabrata represented the most common species. Decreased susceptibility to fluconazole and resistance to itraconazole was associated with all Candida glabrata isolates.
Conclusion: Although PPU-associated peritonitis is mostly of community origin, we confirmed a significant incidence of Candida spp. with decreased azole susceptibility. The choice of antifungal therapy should always be based on local epidemiology.
Keywords:
antifungal susceptibility – antifungal therapy – perforated peptic ulcer – Candida spp.
Sources
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Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2022 Issue 7
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