For patients with gastro-duodenal perforations (156 cases), the most common surgical procedure was gastro-duodenal suture. 107 patients underwent

open gastro-duodenal suture (68.6%) and 18 patients underwent selleck screening library laparoscopic gastro-duodenal suture (11.5%). 16 patients (10.3%) underwent gastro-duodenal resection and 16 patients (10.3%) received conservative treatment (non-operative treatment, surgical drainage). The remaining patients underwent alternative procedures. Of the 100 patients with small bowel perforations, 83 underwent open small bowel resection (83%) and 3 (3%) underwent laparoscopic small bowel resection. The remaining 14 patients (14%) were treated non-surgically. Among the 158 patients with colonic non-diverticular perforation, 52 (32.9%) underwent open Hartmann resection, 55 (34.8%) underwent open resection with anastomosis and without stoma protection, and 23 underwent open resection with stoma protection (14.6%). 369 cases (17.1%) were attributable to post-operative infections. Anastomotic leaks were the most prevalent cause of post-operative infection. Of all post-operative infections, 40.2% resulted from colo-rectal leaks,

32.1% from upper gastro-intestinal leaks, 14.5% from biliary leaks, 11.2% from pancreatic leaks, and 1.9% from urinary leaks. Source control was successfully implemented for 1,985 patients (92%) and proved ineffective for 167 patients (8%). Microbiology Intraperitoneal www.selleckchem.com/products/Fludarabine(Fludara).html specimens were collected from 1,339 patients (62.2%). These specimens were obtained from 977 of the 1,701 patients presenting with community-acquired intra-abdominal infections PRIMA-1MET chemical structure (57.4%). Intraperitoneal specimens were collected from 362 (80.3%) of the remaining 451 patients with nosocomial intra-abdominal infections. The major pathogens involved in intra-abdominal infections

were found to be Enterobacteriaceae. Rutecarpine The aerobic bacteria identified in samples of peritoneal fluid are reported in Table 4. Table 4 Aerobic bacteria identified in peritoneal fluid Total 1,525 (100%) Aerobic Gram-negative bacteria 1,041 (69.2%) Escherichia coli 632 (41.4%) (Escherichia coli resistant to third generation cephalosporins) 64 (4.2%) Klebsiella pneuumoniae 109 (7.1%) (Klebsiella pneumoniae resistant to third generation cephalosporins) 37 (2.4%) Enterobacter 63 (4.1%) Proteus 33 (2.1 %) Pseudomonas 80 (5.2%) Others 124 (8.1%) Aerobic Gram-positive bacteria 484 (31.7%) Enterococcus faecalis 169 (11%) Enterococcus faecium 72 (4.7%) Staphylococcus Aureus 56 (3.7%) Streptococcus spp. 100 (6,6%) Others 87 (5.7%) In community-acquired IAIs, Extended-Spectrum Beta-Lactamase (ESBL)-producing Escherichia coli isolates comprised 10.1% (64/632) of all Escherichia coli isolates, while ESBL-positive Klebsiella pneumoniae isolates represented 33.9% (37/109) of all Klebsiella pneumoniae isolates. ESBL-positive Enterobacteriaceae were more prevalent in patients with nosocomial IAIs than they were in patients with community-acquired IAIs.