International Surgery Journal | March 2025 | Vol 12 | Issue 3 Page 368
International Surgery Journal
Shah N et al. Int Surg J. 2025 Mar;12(3):368-371
http://www.ijsurgery.com
pISSN 2349-3305 | eISSN 2349-2902
Original Research Article
A one-year cross sectional study of peritoneal fluid cultures and
antibiotic sensitivity patterns in cases of surgical peritonitis
Nidhi Shah, Mehnish Malik, S. Deoleker, P. S. Eswar, Zulekha Bhimani*
INTRODUCTION
Peritonitis, a potentially life-threatening condition
characterized by inflammation of the peritoneal cavity,
represents a critical medical emergency that demands
prompt recognition and decisive management. This
condition can arise from a multitude of underlying
etiologies, including perforated viscus, appendicitis,
diverticulitis, pancreatitis, and post-operative
complications.
1
Surgical peritonitis, a subset of peritonitis
that necessitates surgical intervention, poses a formidable
challenge to healthcare professionals and carries a
significant risk of morbidity and mortality.
2
The effective
management of surgical peritonitis hinges upon the timely
administration of appropriate antimicrobial therapy, which
is guided by the identification of the causative microbial
pathogens and their antibiotic susceptibility patterns.
3
In
this context, peritoneal fluid culture and antibiotic
sensitivity testing play a pivotal role, as they provide
invaluable insights to guide empiric and definitive
antimicrobial therapy, thereby optimizing patient
outcomes.
4
The microbial etiology of surgical peritonitis is diverse and
multifaceted, with variations observed depending on a
range of factors, including the underlying cause, patient
demographics, geographic location, and healthcare
settings.
5
Gram-negative organisms, such as Escherichia
coli, Klebsiella pneumoniae, and Pseudomonas
aeruginosa, are commonly implicated in community-
ABSTRACT
Background: Surgical peritonitis is a serious complication with significant morbidity and mortality. Understanding the
microbiological profile and antibiotic sensitivity patterns is crucial for optimal management. This study aimed to
evaluate the peritoneal fluid cultures and antibiotic sensitivity patterns in cases of surgical peritonitis.
Methods: This was a hospital-based prospective study conducted at D. Y. Patil University School of Medicine, Nerul,
Navi Mumbai, over a one-year period. Patients presenting with peritonitis were included, and peritoneal fluid samples
were collected during surgery for microbiological analysis. Antibiotic treatment was guided by the culture and
sensitivity results.
Results: A total of 50 patients were enrolled. The most common etiologies were appendicitis (32%), diverticulitis
perforation (24%), and perforated duodenal/peptic ulcers (44%). The predominant pathogens isolated from peritoneal
fluid cultures were E. coli (16%), Bacteroides fragilis (14%), S. aureus (14%), and Streptococcus anginosus (14%).
Antibiotic sensitivity patterns revealed high susceptibility to multiple antibiotics for E. coli, Bacteroides fragilis, and
Klebsiella pneumoniae. However, Enterococcus faecalis exhibited concerning resistance to vancomycin and linezolid.
Conclusions: This study provides valuable insights into the microbiology and antibiotic susceptibility profiles of
pathogens involved in surgical peritonitis cases. The findings can inform empiric antimicrobial treatment strategies and
guide antibiotic stewardship efforts in the management of this serious condition.
Keywords: Surgical peritonitis, Peritoneal fluid cultures, Antibiotic sensitivity, Microbiology, Antimicrobial resistance
Department of General Surgery, Dr. D. Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India
Received: 22 December 2024
Revised: 23 January 2025
Accepted: 31 January 2025
*Correspondence:
Dr. Zulekha Bhimani,
E-mail: zulekhabhimani10@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/2349-2902.isj20250570