Surgical bacteria pattern following emergency laparotomy at kenyatta national hospital

Background: Surgical site infection (SSI) following emergency laparotomy results in significant morbidity. This study determined microbial pattern and duration of antimicrobial therapy following emergency laparotomy at Kenyatta National Hospital (KNH). Objectives: To determine microbial profile and duration of anti-microbial therapy following emergency laparotomy at KNH. Design: Cross sectional study. Setting: KNH, general surgical unit. Subject: One hundred and twenty (120) patients, 13 years and above scheduled to undergo emergency laparotomy. Results: Thirty point eight (30.8%) percent of patients had SSI. Escherichia coli (E.coli) accounted for 15% (18/120) of all infections as mono-isolate. E.coli and Klebsiella pneumonia accounted for most of poly-microbial infection at 3.3% (4/120). There were no anaerobic isolates. Twenty nine point percent (35/120) of patients who received antibiotic therapy for more than 5 days accounted for most of infections at 23.3%(28/120). Conclusion: E.coli remains the most significant single infectious agent in this study. The other less occurring bacteria were Enterobacter spp., staphylococcus spp., streptococcus spp. and Klebsiella spp. Cost benefit analysis on the need for anti-biotics targeting anaerobic therapy might be useful. Judicial use of anti-biotics targeting microbialspectrum with therapy duration of five dayswithin our surgical units might reduce risk of infections and anti-microbial resistance.