SPECTRUM OF PATHOGENS AND RESISTANCE IN P ERITONITIS

Severe intra-abdominal infection is associated with a high mortality r ate. In addition to risk factors in the patients, the causal pathogens and the selection of appropriate therapeutic procedures play an essen tial part in the course of these conditions. In the majority of intra- abdominal infections mixed aerobic/anaerobic infections, mostly with s ome involvement of enterobacteria and also of enterococci and staphylo cocci can be demonstrated. In addition to surgical intervention a calc ulated antimicrobial initial treatment of intra-abdominal infections w ith an antibiotic with an adequate effect to combat the pathogen conce rned can contribute to improving the patient's prognosis. A calculated antibiotic treatment can only be effectively and reliably carried thr ough if the frequency of the pathogen and the restistance situation ar e known. Retrospective evaluations of data on the sensitivity and freq uency of pathogens from a defined group of subjects allow conclusions on the epidemiological situation in a particular catchment area or in a medical sector and thus make it possible to calculate the appropriat e therapy for infections. In 1996 a total of 2,779 bacterial isolates from the intra-abdominal infection sector were examined: 935 Enterobac teriaceae, 83 nonfermenters, 177 Staphylococcus spp., 211 Enterococcus spp., 39 Streptococcus spp., and 1334 different anaerobic bacteria. F resh clinical isolates were available for all pathogens tested. The mo st frequent gram-negative pathogen was E. coli (60%) and the most freq uent gram-positive pathogen, E. faecalis (44%); the most frequent anae robic pathogen was B. fragilis (39%). Taurolodine had the lowest resis tance rate against gramnegative and anaerobic pathogens. Teicoplanin h ad the highest activity against gram-positive pathogens.