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4 . 2021

Comparative results of bacterial study of peritoneal exudate in secondary generalized peritonitis

Abstract

An important role in determining the tactics of treatment in patients with secondary generalized peritonitis plays identification of microorganisms - infectious agents. The bacteriological method is the "gold standard" for identification of etiopathogens, but it takes a long time and has a low sensitivity.

The aim - to study possibilities to detect microbial composition of peritoneal exudate by gas chromatography-mass spectrometry (GC-MS) in secondary generalized peritonitis in comparison with traditional bacteriological research.

Material and methods. We studied the features of the microbial composition of peritoneal exudate in 42 patients who were treated in the surgical department of Clinical Hospital № 4 (Perm), in the period from May to December 2019 for secondary generalized peritonitis of various origins. Exudates were studied by bacteriological method and GC-MS.

Results. According to the bacteriological study, 24 (57.14%) samples of peritoneal exudate were positive. In total, 33 bacterial cultures were identified, the most common were enterobacteria (23; 69.69%), non-fermenting gram-negative bacteria (6; 18.18%). According to GC-MS, traces of the presence of microorganisms were detected in all investigated exudates. The analysis of the species composition made it possible to identify representatives of 24 species belonging to 4 large phyla: Actinobacteria, Firmicutes, Proteobacteria and Bacteroidetes. Most of them were minor associates of the polymicrobial consortium.

Conclusion. Etiopathogens diagnosis of complicated abdominal surgical infection by GC-MS is faster, more sensitive and versatile. The disadvantages of the method are inability to differentiate between living and non-viable microorganisms, to assess their antibiotic sensitivity.

Keywords:secondary peritonitis, generalized peritonitis, microorganisms, bacteriological examination, gas chromatography - mass spectrometry

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Samartcev V.A., Kuznetsova M.P., Gavrilov V.A., Pushkarev B.S., Maslennikova I.L., Kuznetsova M.V. Comparative results of bacterial study of peritoneal exudate in secondary generalized peritonitis. Clinical and Experimental Surgery. Petrovsky Journal. 2021; 9 (4): 111-7. DOI: https://doi.org/10.33029/2308-1198-2021-9-4-111-117 

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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