Etiological structure and antibiotic resistance of pathogens causing secondary peritonitis

Relevance. Antibiotic resistance (ABR) is one of the major threats to public health worldwide. In abdominal surgery, a complex clinical task is the treatment of secondary peritonitis, which, on the one hand, is accompanied by a high risk of developing abdominal sepsis, on the other hand, is associated with a wide range of microorganisms with different levels of ABR. Aims. To study the etiological structure and prevalence of resistance to ABP in pathogens of secondary peritonitis. Material and methods. A retrospective analysis of 120 cases of hospitalization of patients with secondary peritonitis in the period from 2021 to 2023 in the Regional State Autonomous Healthcare Institution “City Clinical Hospital No. 3 named after B.I. Alperovich” (Tomsk) was carried out. 139 isolates were studied based on the results of bacteriological examination of the contents of the abdominal cavity. Results. Representatives of the order Enterobacterales (E. coli, K. pneumoniae, P. mirabilis) prevailed in the structure of secondary peritonitis pathogens. Mixed infection, represented by a combination of K. pneumoniae with other pathogens, mainly E. faecalis, E. coli and P. aeruginosa, was detected in 22.5% of cases. Among the identified pathogens, K. pneumoniae and E. coli isolates characterized by an unfavorable ABR profile to cephalosporins, penicillins and fluoroquinolones were of concern. Conclusions. The etiological structure of secondary peritonitis is represented by a wide range of pathogens characterized by different levels of ABR. The main etiological role belongs to gram-negative bacteria. The causative agents of secondary peritonitis are characterized by different levels of ABR to the main groups of antibiotics used in clinical practice. The obtained data may be useful for the formation of local tactics of empirical antibacterial therapy.

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