Bacteriology of Peritonitis in Children Treated at the University Hospital of Marrakech
American Journal of Laboratory Medicine
Volume 4, Issue 5, September 2019, Pages: 87-90
Received: Sep. 7, 2019;
Accepted: Sep. 24, 2019;
Published: Oct. 17, 2019
Views 40 Downloads 19
Taoufik Rokni, Department of Microbiology, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco
Adil Rabi, Department of Microbiology, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco
Nabila Soraa, Department of Microbiology, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco
Hassan Ait Bahssain, Department of Pediatric Anesthesia-reanimation, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco
Younous Said, Department of Pediatric Anesthesia-reanimation, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco
Tarik Salama, Department of Pediatric Anesthesia-reanimation, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco
Fouraiji Karima, Department of Pediatric Surgery, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco
Kamili El Ouafi El Aouni, Department of Pediatric Surgery, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco
Oulad Saiad Mohamed, Department of Pediatric Surgery, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco
Follow on us
Child peritonitis are severe intra-abdominal infections, involving vital prognosis. The available microbiological data of peritonitis in children are inadequate, and antibiotic therapy is not consensual. Description of the bacteriological profile and the antibiotic resistance of the isolated bacteria in the various samples of peritoneal fluid from the different departments of the University Hospital of Marrakech. It is a descriptive study spread over two years. carried out at the Laboratory of Microbiology of the Mohamed VI Hospital of Marrakech (CHU MED VI), covering all the bacterial strains, isolated in the peritoneal fluid samples from the various pediatric departments of the University Hospital. During this period, 92 samples were treated in the laboratory with a positivity rate of 80%. The average age of his children is 11.7 years with a sex ratio of 1.4. The infection was polymicrobial in 40%. Escherichia. coli dominated the bacteriological profile of these peritonitis in 74% of cases, followed by Streptococcus spp (30%), Pseudomonas aeruginosa (18%), Enterobacter cloacae (6%) and Klebsiella pneumoniae (1%). The susceptibility to amoxicillin in enterobacteria isolated from peritonitis was 32%, 68% for amoxicillin/clavulanic acid, 92% for 3rd generation cephalosporins, 97% for fluoroquinolones, 67% for cotrimoxazole and 89% for gentamycin. Only one strain of Pseudomonas aeruginosa was resistant to ceftazidime. All strains remained sensitive to amikacin and carbapenems. Resistance of Enterobacteria to 3rd generation cephalosporins by the production of Extended Spectrum Betalactamase (ESBL) in the isolates was 4%. This prompts us to reconsider our therapeutic approach. We believe that the association C3G + aminoglycoside + metronidazole should be used first-line in severe pediatric peritonitis in our context. The quick initiation of an antibiotic therapy adapted to the resistance profile would be an important factor in improving the prognosis, hence the interest of close collaboration between surgeons, anesthesiologist-intensive care and microbiologists.
Peritonitis, Antibiotherapy, Pediatrics
To cite this article
Hassan Ait Bahssain,
Kamili El Ouafi El Aouni,
Oulad Saiad Mohamed,
Bacteriology of Peritonitis in Children Treated at the University Hospital of Marrakech, American Journal of Laboratory Medicine.
Vol. 4, No. 5,
2019, pp. 87-90.
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Bourgoin A, Leone M, Marti C. Prise en charge thérapeutique des péritonites. Med Mal Infect 2004; 34: 183-95.
Société Française d’Anesthésie-Réanimation. Prise en charge des péritonites communautaires - conférence de consensus - texte court. Ann Fr Anesth Reanim 2001; 20: 368s-73s.
Nejmi H, Laghla B, Boutbaoucht M, Samkaoui MA. Evolution des résistances de l’Escherichia coli au cours des péritonites communautaires. Med Mal Infect 2011; 41: 213-20.
Mahamoudou Sanou, Armand Ky, Caractérisation de la flore bactérienne des péritonites communautaires opérées au Burkina Faso; The Pan African Medical Journal. 2014; 18: 17.
Leone M, Boyadjiev I, Martin C. Péritonites communautaires: quelle antibiothérapie probabiliste? Urg Prat 2007; 80: 31-4.
J. B. Dever, M. Y. Sheikh. Spontaneous bacterial peritonitis – bacteriology, diagnosis, treatment, risk factors and prevention. Alimentary pharmacology and therapeutics; volume 41, Issue11, June 2015; 1116-1131.
Montravers P, Lepape A, Dubreuil L, Gauzit R, Pean Y, Benchimol D, Dupont H. Clinical and microbiological profiles of community-acquired and nosocomial intra-abdominal infections: results of the French prospective, observational EBIIA study. J Antimicrob Chemother 2009; 63: 785-94.
Montravers P, Jean-Baptiste S, Tashk P, Péritonites. Le Congrès. Médecins. Conférence d’Essentiel, 2016.
Dumont R, Cinotti R, Lejus C, Caillon J, Boutoille D, Roquilly A, et al. The microbiology of community-acquired peritonitis in children. Pediatr Infect Dis, J 2011; 30: 131–5.
Newman N, Wattad E, Greenberg D, Peled N, Cohen Z, Leibovitz E. Community acquired complicated Intra abdominal infections in children hospitalized during 1995–2004 at a paediatric surgery department. Scand J Infect Dis 2009; 41: 720–6.
Soussy CJ. Comité de l'antibiogramme de la société française de microbiologie. Communiqué 2010 - 2011. Path Biol. 2010; 48: 832-71. PubMed | Google Scholar.
Hawser SP, Bouchillon SK, Hoban DJ, Badal RE. In vitro susceptibilities of aerobic and facultative anaerobic Gram negative bacilli from patients with intra-abdominal infections worldwide from 2005–2007: results from the SMART study. Int J Antimicrob Agents 2009; 34: 585–8.
Profil bactériologique des péritonites communautaires de l’enfant prises en charge au CHU de Marrakech 2012 Published by Elsevier Masson SAS on behalf of the Société francaise d’anesthésie et de réanimation (Sfar).
Nadler EP, Gaines BA, Therapeutic Agents Committee of the Surgical Infection Society. The Surgical Infection Society guidelines on antimicrobial therapy for children with appendicitis. Surg Infect (Larchmt) 2008; 9: 75–83.
Rodrıguez-Ban o J, Navarro MD. Extended-spectrum beta-lactamases in ambulatory care: a clinical perspective. Clin Microbiol Infect 2008; 14 (Suppl. 1): 104–10.
Kilian Friedrich, Simone Nüssle, Tobias Rehlen. Microbiology and resistance in first episodes of spontaneous bacterial peritonitis: implications for management and prognosis, Journal of gastroenterology and hepatology; volume31, Issue6, June 2016 Pages 1191-1195.
W. Zhang, Y. Wu, X. Qi, H. Dai, W. Lu and M. Zhao, "Peritoneal Dialysis-Related Peritonitis with Acinetobacter baumannii: A Review of Seven Cases", Peritoneal Dialysis International, vol. 34, no. 3, pp. 317-321, 2013.
Sartelli M. A focus on intra-abdominal infections. World J Emerg Surg 2010; 5: 2–20.
Ji Young Jang, Seung Hwan Lee, Epidemiology and Microbiology of Secondary Peritonitis Caused by Viscus Perforation: A Single-Center Retrospective Study Surgical Infections; Vol. 16, No. 4; Published Online: 24 Jul 2015.