Distribution and drug resistance analysis of pathogens in early-stage digestive tract perforation complicated with peritonitis

Abstract

To investigate the distribution and drug resistance of pathogens associated with early-stage digestive tract perforation with peritonitis. A retrospective analysis was conducted on patients with digestive tract perforation and peritonitis at Huadu District People's Hospital of Guangzhou from Jan. 2020 to Aug. 2024. The selected patients were divided into two groups: the upper digestive tract (UDT) group and the lower digestive tract (LDT) group. General clinical characteristics and intraoperative secretions culture results were compared and analyzed. The study included 831 patients; 41.28% were in UDT group followed 58.72% in LDT group. 694 strains that isolated comprised 503 Gram-negative bacteria (GNB), 93 g-positive bacteria (GPB) and 98 fungi. Compared to LDT group, the UDT group had a higher positive rate of GPB and fungi but a lower positive rate of GNB. The most common pathogens among GNB were E.coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae; among GPB were Streptococcus anginosus, Enterococcus aviae, and Streptococcus constellations; among fungi were Candida albicans, Candida glabrata, and Candida Cruxalis. We further analyzed drug susceptibility results to related antibacterial drugs. The findings from this study have significant implications for guiding initial empirical antimicrobial therapy for patients with digestive tract perforation and peritonitis.

Keywords: Digestive tract perforation; Drug resistance; Pathogen; Peritonitis.

Fig. 1

Early antibiotic selection strategy Notes: The Green-Strategy was applied to the cases of non-severe digestive tract perforation complicated with peritonitis, while the Orange-Strategy to severe cases. GNB, Gram-negative bacterium; GPB, gram-positive bacterium.