PERITONEAL FLUID BACTERIOLOGY IN CASES OF PERFORATIVE PERITONITIS DUE TO GASTROINTESTINAL PERFORATIONS WITH SPECIAL REFERENCE TO ITS MANAGEMENT & OUTCOME

Charan Panda; Ravi Teja P; Sushanta Kumar Das

Volume : VII, Issue : I, January - 2018

PERITONEAL FLUID BACTERIOLOGY IN CASES OF PERFORATIVE PERITONITIS DUE TO GASTROINTESTINAL PERFORATIONS WITH SPECIAL REFERENCE TO ITS MANAGEMENT & OUTCOME

Charan Panda, Ravi Teja P, Sushanta Kumar Das

Abstract :

BACKGROUND: Perforative peritonitis is one of the most common surgical emergencies in India.¹ Perforation of the intestines results in the potential for bacterial contamination resulting in peritonitis.

MATERIALS & METHODS: A total of 244 patients (July 2015–June 2017) who presented with features of peritonitis admitted to various surgical units of M.K.C.G. Medical College Hospital, Berhampur were included in this study. The following study was conducted to analyse bacteriology of peritoneal fluid, to assess antibiotic sensitivity pattern, to assess its impact on morbidity, mortality pattern in these cases.

RESULT: Males outnumbered females with a ratio 4.6:1. The most common site of perforation was First part of Duodenum (57.01%), followed by Ileum (22.95%). Peritoneal Fluid was negative for culture (37.3%) in majority of cases, culture was positive for E coli in 24.2% of cases and Enterococcus in 8.2% of cases respectively. The antibiotic sensitivity pattern for E coli, Enterococcus, Streptococcus, Staphylococcus was almost the same in my study. Majority of the isolated strains were sensitive to Cephalosporins, Quinolones, Aminoglycosides. The most common postoperative complications were wound infection, respiratory complications, Death

CONCLUSION:

Perforative peritonitis is one of the common surgical emergencies in India. Studies have shown that delay in management and treatment will affect the prognosis. Empiric antimicrobial therapy is initiated and changed accordingly with peritoneal fluid culture sensitivity reports. This may reduce the incidence of post–operative complications, morbidity and mortality