Apa from Escherichia coli, the other most common organism implicated in acute suppurative bacterial peritonitis is

Bacteroides are commonly found in peritonitis. These Gram-negative, non-sporing organisms, although predominant in the lower intestine, often escape detection because they are strictly anaerobic and slow to grow on culture media unless there is an adequate carbon dioxide tension in the anaerobic apparatus (Gillespie). In many laboratories, the culture is discarded if there is no growth in 48 hours. These organisms are resistant to penicillin and streptomycin but sensitive to metronidazole, clindamycin, lincomycin and cephalosporin compounds. Since the widespread use of metronidazole (Flagyl), Bacteroides infections have greatly diminished. When bacteria contaminate the peritoneum as a result of spillage from an intra-abdominal viscus.* Infection in secondary bacterial peritonitis is polymicrobial* E. coli and Bacteroides are MC organisms.* The species of organism isolated vary with the source of the initial process and the normal flora present at the site. * Peritonitis is one of the MC complications of CAPDQ, occurring with an incidence of approximately one episode every 1 to 3 years.* Refractory or recurrent peritonitis is MC cause of technical failure of CAPD.* MC organism: Staphylococcus epidermidis (30-50%). Clinical Features* Patients present with abdominal pain, fever, and cloudy peritoneal dialysate containing >100 WBC/mm3, with >50% of the cells being neutrophils.* Gram staining detects organisms only in 10-40% of cases. Treatment* CAPD associated peritonitis is treated by the intraperitoneal administration of antibiotics, usually a first-generation cephalosporin.* Overall, 75% of infections are cured by culture-directed antibiotic therapy.* Recurrent or persistent peritonitis requires removal of the dialysis catheter and resumption of hemodialysis Reference:Bailey & Love's sho practise of surgery,25th edition,page no:992