Peritonitis caused by Aeromonas species at a hospital in southern Taiwan.
OBJECTIVE
This study was conducted to investigate the clinical characteristics of patients with Aeromonas peritonitis, particularly secondary peritonitis.


METHODS
Patients with Aeromonas peritonitis treated between July 2004 and December 2011 were identified from the computerized database of a regional hospital in southern Taiwan. The medical records of these patients were retrospectively reviewed.


RESULTS
A total of 50 patients with Aeromonas peritonitis were identified. Nine cases were classified as spontaneous bacterial peritonitis, and 41 cases were classified as secondary peritonitis. The most common etiology of secondary peritonitis was acute appendicitis (n=26), followed by small bowel perforation (n=7) and colon perforation (n=6). The patients with spontaneous bacterial peritonitis were more likely to be immunocompromised (p=0.0013) and more frequently had an initial presentation of shock (p=0.0129), an abnormal liver function (p<0.05) and concomitant bacteremia (p=0.0024) than the patients with secondary peritonitis. Although the patients with secondary peritonitis had higher levels of inflammatory parameters, including leukocytes and C-reactive protein, and more frequent polymicrobial infections, their survival outcome rates, such as in-hospital mortality, were significantly lower (p=0.0007). The overall in-hospital mortality rate was 20%, and initial shock was the only independent prognostic factor for mortality (p=0.012).


CONCLUSIONS
The clinical characteristics, including outcomes, of patients with spontaneous and secondary Aeromonas peritonitis differ. In-hospital mortality is significantly associated with the initial presentation of shock.
Department of Orthopaedics, Chi Mei Medical Center, Taiwan.
Wei-Ting
WT
Lin
Shih-Yang
SY
Su
Chih-Cheng
CC
Lai
Tsung Chih
TC
Tsai
Shiow-Jen
SJ
Gau
Chien-Ming
CM
Chao
D000293:Adolescent; D000328:Adult; D000333:Aeromonas / Q000302:isolation & purification / Q000472:pathogenicity*; D000368:Aged; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000382:microbiology*; D006773:Hospitals, Municipal; D006801:Humans; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000175:diagnosis / Q000382:microbiology*; D011379:Prognosis; D013624:Taiwan; D055815:Young Adult