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Antibiotic sensitivity in correlation to the origin of secondary peritonitis: a single center analysis

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Antibiotic sensitivity in correlation to the origin of secondary peritonitis: a single center analysis. / Grotelüschen, Rainer; Heidelmann, Lena M; Lütgehetmann, Marc; Melling, Nathaniel; Reeh, Matthias; Ghadban, Tarik; Dupree, Anna; Izbicki, Jakob R; Bachmann, Kai A.

In: SCI REP-UK, Vol. 10, No. 1, 29.10.2020, p. 18588.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Grotelüschen, R, Heidelmann, LM, Lütgehetmann, M, Melling, N, Reeh, M, Ghadban, T, Dupree, A, Izbicki, JR & Bachmann, KA 2020, 'Antibiotic sensitivity in correlation to the origin of secondary peritonitis: a single center analysis', SCI REP-UK, vol. 10, no. 1, pp. 18588. https://doi.org/10.1038/s41598-020-73356-x

APA

Grotelüschen, R., Heidelmann, L. M., Lütgehetmann, M., Melling, N., Reeh, M., Ghadban, T., Dupree, A., Izbicki, J. R., & Bachmann, K. A. (2020). Antibiotic sensitivity in correlation to the origin of secondary peritonitis: a single center analysis. SCI REP-UK, 10(1), 18588. https://doi.org/10.1038/s41598-020-73356-x

Vancouver

Grotelüschen R, Heidelmann LM, Lütgehetmann M, Melling N, Reeh M, Ghadban T et al. Antibiotic sensitivity in correlation to the origin of secondary peritonitis: a single center analysis. SCI REP-UK. 2020 Oct 29;10(1):18588. https://doi.org/10.1038/s41598-020-73356-x

Bibtex

@article{6ec492f823ad4b3d9500a93192082586,
title = "Antibiotic sensitivity in correlation to the origin of secondary peritonitis: a single center analysis",
abstract = "Despite improvements in diagnosis, intensive-care medicine and surgical technique, the mortality of patients with secondary peritonitis is still high. Early and aggressive empiric antibiotic treatment has strong impact on the outcome. This retrospective study investigates bacterial and fungal pathogens and their antibiotic sensitivity in patients with secondary peritonitis. All patients that underwent emergency laparotomy due to secondary peritonitis at the Department of Surgery, University Medical Center Hamburg-Eppendorf between 2005 and 2015 were reviewed and overall 414 patients were included. We correlated the intra-abdominal localization of the organ perforation with intraoperative microbiological findings and corresponding sensitivities to relevant antibiotics. Overall, the most common findings were Escherichia coli (39%) and other Enterobacterica (24%). Depending on the location of the perforation, Cefuroxime/Metronidazole and Cefutaxime/Metronidazole were effective (based on in vitro susceptibility testing) in only 55-73% of the patients, while Meropenem/Vancomycin was able to control the peritonitis in more than 98% of the patients; independent of the location. Besides early source control, appropriate empiric treatment plays a pivotal role in treatment of secondary peritonitis. We are able to show that the frequently used combinations of second or third generation Cephalosporins with Metronidazole are not always sufficient, which is due to the biological resistance of the bacteria. Further clinical studies are needed to determine whether calculated use of broad-spectrum antibiotics with a sensitivity rate > 99%, such as Carbapenem plus Vancomycin, can improve overall survival rates in critically ill patients with secondary peritonitis.",
author = "Rainer Grotel{\"u}schen and Heidelmann, {Lena M} and Marc L{\"u}tgehetmann and Nathaniel Melling and Matthias Reeh and Tarik Ghadban and Anna Dupree and Izbicki, {Jakob R} and Bachmann, {Kai A}",
year = "2020",
month = oct,
day = "29",
doi = "10.1038/s41598-020-73356-x",
language = "English",
volume = "10",
pages = "18588",
journal = "SCI REP-UK",
issn = "2045-2322",
publisher = "NATURE PUBLISHING GROUP",
number = "1",

}

RIS

TY - JOUR

T1 - Antibiotic sensitivity in correlation to the origin of secondary peritonitis: a single center analysis

AU - Grotelüschen, Rainer

AU - Heidelmann, Lena M

AU - Lütgehetmann, Marc

AU - Melling, Nathaniel

AU - Reeh, Matthias

AU - Ghadban, Tarik

AU - Dupree, Anna

AU - Izbicki, Jakob R

AU - Bachmann, Kai A

PY - 2020/10/29

Y1 - 2020/10/29

N2 - Despite improvements in diagnosis, intensive-care medicine and surgical technique, the mortality of patients with secondary peritonitis is still high. Early and aggressive empiric antibiotic treatment has strong impact on the outcome. This retrospective study investigates bacterial and fungal pathogens and their antibiotic sensitivity in patients with secondary peritonitis. All patients that underwent emergency laparotomy due to secondary peritonitis at the Department of Surgery, University Medical Center Hamburg-Eppendorf between 2005 and 2015 were reviewed and overall 414 patients were included. We correlated the intra-abdominal localization of the organ perforation with intraoperative microbiological findings and corresponding sensitivities to relevant antibiotics. Overall, the most common findings were Escherichia coli (39%) and other Enterobacterica (24%). Depending on the location of the perforation, Cefuroxime/Metronidazole and Cefutaxime/Metronidazole were effective (based on in vitro susceptibility testing) in only 55-73% of the patients, while Meropenem/Vancomycin was able to control the peritonitis in more than 98% of the patients; independent of the location. Besides early source control, appropriate empiric treatment plays a pivotal role in treatment of secondary peritonitis. We are able to show that the frequently used combinations of second or third generation Cephalosporins with Metronidazole are not always sufficient, which is due to the biological resistance of the bacteria. Further clinical studies are needed to determine whether calculated use of broad-spectrum antibiotics with a sensitivity rate > 99%, such as Carbapenem plus Vancomycin, can improve overall survival rates in critically ill patients with secondary peritonitis.

AB - Despite improvements in diagnosis, intensive-care medicine and surgical technique, the mortality of patients with secondary peritonitis is still high. Early and aggressive empiric antibiotic treatment has strong impact on the outcome. This retrospective study investigates bacterial and fungal pathogens and their antibiotic sensitivity in patients with secondary peritonitis. All patients that underwent emergency laparotomy due to secondary peritonitis at the Department of Surgery, University Medical Center Hamburg-Eppendorf between 2005 and 2015 were reviewed and overall 414 patients were included. We correlated the intra-abdominal localization of the organ perforation with intraoperative microbiological findings and corresponding sensitivities to relevant antibiotics. Overall, the most common findings were Escherichia coli (39%) and other Enterobacterica (24%). Depending on the location of the perforation, Cefuroxime/Metronidazole and Cefutaxime/Metronidazole were effective (based on in vitro susceptibility testing) in only 55-73% of the patients, while Meropenem/Vancomycin was able to control the peritonitis in more than 98% of the patients; independent of the location. Besides early source control, appropriate empiric treatment plays a pivotal role in treatment of secondary peritonitis. We are able to show that the frequently used combinations of second or third generation Cephalosporins with Metronidazole are not always sufficient, which is due to the biological resistance of the bacteria. Further clinical studies are needed to determine whether calculated use of broad-spectrum antibiotics with a sensitivity rate > 99%, such as Carbapenem plus Vancomycin, can improve overall survival rates in critically ill patients with secondary peritonitis.

U2 - 10.1038/s41598-020-73356-x

DO - 10.1038/s41598-020-73356-x

M3 - SCORING: Journal article

C2 - 33122689

VL - 10

SP - 18588

JO - SCI REP-UK

JF - SCI REP-UK

SN - 2045-2322

IS - 1

ER -