Acute panperitonitis is one of many critical surgical disease, and there are many problems in its treatment, though the antibiotics therapy and fluid and electrolyte therapy, etc. are employed. The development of antibiotics made an epoch in the management of acute panperitonitis, and so the surgical infections can be prevented without any difficulty. But the overuse of antibiotics and the appearance of antibiotic resistant strains have made a new, problem in surgical infection.
To achieve the most effective management of acute panperitonitis, the culture of peritoneal fluid on exploratory laparotomy and the antibiotic sensitivity test to microorganisms are needed.
In this paper, 188 cases of abdominal surgery (107 cases of non-peritonitis and 81 cases of acute panperitonitis) were examined with the bacterial cultures of peritoneal fluid with 5l sheep blood agar in each case to study the kinds of bacteria, the detection rate of bacteria, `the relation between the time from´hollow viscus rupture to operation, wound infection and mort-ality, rate, and the: antibiotics sensitivity test to microorganisms.
The results obtained are as follows;
1. In 107 cases of non-peritonitis, 97 cases (90.7%), were negative, and 10 cases (9: 3%), positive. A total of 14 strains´ were found in 10 positive cases, E. coli being in 8 strains (57.1%), which was the largest in number.
2. 45 cases (55.6%) were positive, and 36 cases (44.4°/), negative, in 81 cases of acute pan-peritonitis. The detection rate of bacteria in the following diseases was 12 cases (85.7%) out of 14 cases of typhoid perforation 8 cases (80.0%) out of 10 cases of traumatic intestinal perfor-ation, 11 cases (40.7%) out of 27 cases of perforated appendicitis and 8 cases (38.1%) out of 21 cases of peptic ulcer perforation.
3. In 81 cases of acute panperitonitis, a total of 61 strains were found out of 45 positive cases, which consisted of 40 strains (65.6%) of E. coli, 5 strains (8,2%) of ?-hemolytic strept-ococcus, 4 strains .(6.6%) of staphylococcus aureus and 3 strains (4.9%) of pseudomonas aerug-inosa, etc.
4. 4 strains (36.7%) of hemolytic streptococcus, 3 strains (20.0%) of staphylococcus aureus were found in, a total of 13 strains of peptic ulcer perforation and it was noticed that the detection rate (46.7%) of Gram positive group in this disease was higher than the rate of other kinds of acute panperitonitis.
5. In acute panperitonitis due to hollow viscus rupture, the relation between the time of perfor-ation and that of operation showed a tendency of increasing the detection rate of bacillus in the peritoneal fluid and the wound infection rate over 60 percent in about 24 hours. The mortality after operation was 3 cases (3.7%) whose operations were performed after 72 hours. Out of the three, the two died of typhoid perforation and the cause of death was septicemia.
6. In sensitivity test to the microorganisms, staphylococcus aureus and ?-hemolytic streptoco ccus were most sensitive to gentamycin geopen and kanamycin, and pseudomonas aeruginosa, to geopen and gentamycin.
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