Ahmetagic Aldina, Numanovic Fatima, Ahmetagic Sead, Rakovac-Tupkovic Lejla, Porobic-Jahic Humera
Department of Clinical Pharmacology, University Clinical Center Tuzla, Bosnia and Herzegovina.
Polyclinic of Laboratory diagnostics, Department of Microbiology, University Clinical Center Tuzla, Bosnia and Herzegovina.
Med Arch. 2013;67(4):278-81. doi: 10.5455/medarh.2013.67.278-281.
To determine the etiology of peritonitis, as well as the sensitivity of isolated bacteria to antibiotics.
Study was performed at the Surgical Clinic, Department of Anesthesiology and Reanimation, Department of Microbiology, Department of Clinical Pharmacology of University Clinical Centre (UCC) Tuzla. In a prospective study, starting from 1.6.2009. to 30.6.2010., was 60 patients analyzed who underwent surgery for acute peritonitis in the Surgical Clinic, UCC Tuzla.
After microbiological processing of the content of the operative field, wound swabs and smears of drainage, we isolated Gram positive coccid bacteria: Coagulase-negative Staphylococcus in 18.36%, Staphylococcus aureus in 12.6%, while Enterococcus faecalis and Enterococcus faecum were found in 3.44% isolates. In the group of Gram-negative bacteria we isolated: Escherichia coli in 15.51%, and Pseudomonas aeruginosa and Klebsiella pneumoniae in 10.34% of the cases. The sensitivity of coagulase-negative Staphylococcus was largest to vancomycin (100%), and lowest to penicillin (10%) and Staphylococcus aureus sensitivity was largest to vancomycin and amoxicillin-clavulanate (100%) and lowest to penicillins (3.7%). Sensitivity of the facultative anaerobic Gram-negative bacilli was highest to carbapenems 95-100%, and lowest to penicillin preparations 0-56%.
Based on the results of microbiological findings of 83.33% patients empirical antibiotic therapy was appropriately involved, and in 16.67% was inadequate and later changed, following the results of microbiological findings. This study indicates the importance and validity of microbiological diagnostics to determine the etiology of peritonitis and appropriate selection of antibiotics to treat these infections, with the required surgical treatment.
确定腹膜炎的病因以及分离出的细菌对抗生素的敏感性。
研究在图兹拉大学临床中心（UCC）的外科诊所、麻醉与复苏科、微生物科、临床药理科进行。在一项前瞻性研究中，从2009年6月1日至2010年6月30日，对在图兹拉大学临床中心外科诊所接受急性腹膜炎手术的60例患者进行了分析。
对手术区域内容物、伤口拭子和引流液涂片进行微生物处理后，我们分离出革兰氏阳性球菌：凝固酶阴性葡萄球菌占18.36%，金黄色葡萄球菌占12.6%，而粪肠球菌和屎肠球菌在分离菌株中占3.44%。在革兰氏阴性菌组中，我们分离出：大肠杆菌占15.51%，铜绿假单胞菌和肺炎克雷伯菌在10.34%的病例中被分离出。凝固酶阴性葡萄球菌对万古霉素的敏感性最高（100%），对青霉素的敏感性最低（10%），金黄色葡萄球菌对万古霉素和阿莫西林 - 克拉维酸的敏感性最高（100%），对青霉素的敏感性最低（3.7%）。兼性厌氧革兰氏阴性杆菌对碳青霉烯类药物的敏感性最高，为95 - 100%，对青霉素制剂的敏感性最低，为0 - 56%。
根据83.33%患者的微生物学检查结果，经验性抗生素治疗应用得当，16.67%的治疗不充分，随后根据微生物学检查结果进行了更改。本研究表明微生物学诊断对于确定腹膜炎病因以及合理选择抗生素治疗这些感染并配合所需手术治疗的重要性和有效性。
