European Journal of Cardiovascular Medicine

Introduction: Amidst the growing scare of antibiotic resistance, the institution of appropriate antibiotic therapy is imperative in the proper management of perforation peritonitis. Objective:In this study, the objective was to find out the common microbial involvement in cases of gastrointestinal perforation along-with their sensitivity to commonly used antibiotics.Methods: This was a retrospective, multi-centric observational study conducted in four tertiary care hospitals of a developing country over a period of 12 years. The records of all the patients operated for gastrointestinal perforation peritonitis during this period were retrieved and analysed. Only those patients were included in the study in which the culture/sensitivity reports of peritoneal fluid were available.Results: A total of 1312 patients were included, among which, 854 (65.1%) were males and 458 (34.9%) were females. The mean age of the patients was 47.1 ± 13.8 years. Upper gastrointestinal perforations were identified in 362 (27.7%) patients and lower gastrointestinal perforations were seen in 943 (71.9%) patients. A single bacterium was isolated in 665 (59.9%) patients, and two bacteria were isolated in 245 (22.1%) patients. The most common organism to be cultured was Escherechia coli [644 (58.1%) patients]. The frequency of sensitivity for each microbe was highest for meropenem (P<0.05).Conclusion: We conclude that Gram-negative Enterobacteriaceae are the usual suspects in cases of perforation peritonitis, and are usually sensitive to meropenem.