Aerobic bacteriological profile and antibiotic sensitivity pattern of peritoneal fluid isolates in patients with intra-abdominal infections due to perforated intra-abdominal viscus in two Tertiary Care Hospitals in Colombo, Sri Lanka

This study aimed to determine the aerobic bacteriological profile and antibiotic sensitivity pattern of peritoneal fluid isolates in patients presenting with intra-abdominal infections due to perforated abdominal viscus /viscera to guide empiric antibiotic therapy. A descriptive study was carried out involving in-ward patients with evidence of intra-abdominal infections due to perforated abdominal viscus following surgery in Colombo South Teaching Hospital (CSTH) and National Hospital of Sri Lanka (NHSL) from 21/11/2022 to 20/03/2023. Forty-nine patients, who had undergone laparotomy were recruited. The majority (91.9%) of the peritoneal fluid isolates were Gram negatives: Escherichia coli (33.9%) and Klebsiella pneumoniae (19.4%). Meropenem, amikacin and piperacillin-tazobactam demonstrated a sensitivity of 89.5%, 68.4%, 89.5% for coliforms respectively in appendicular perforations and 100%, 80%,75% in small intestinal perforations, highlighting their role as the most reliable therapeutic option. Based on in vitro susceptibility data, higher resistance rates were observed for ampicillin (88%), amoxicillin-clavulanate (64%), and cefuroxime (56%). Study data indicate that these agents are unsuitable as monotherapy options.