Abstract
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.
Highlights
Child peritonitis are severe intra-abdominal infections, involving vital prognosis
In adults, the antibiotic therapy of these intra-abdominal infections was the subject of a French consensus conference recommending the use of amoxicillin-clavulanic acid and aminoglycoside [2]
All children hospitalized at the University Hospital of Marrakech who have made a peritoneal sample on an intra-abdominal collection or an echo or scanno-guided puncture of the peritoneal fluid in a postoperative context
Summary
Child peritonitis are severe intra-abdominal infections, involving vital prognosis. They require both a surgical gesture with emergency antibiotic therapy. This antibiotherapy precedes and completes the surgical procedure, with the aim of controlling bacteremia and the spread of infection [1]. Epidemiological and microbiological data available on community peritonitis of the child are insufficient, and antibiotic therapy does not still the subject of a consensus. In adults, the antibiotic therapy of these intra-abdominal infections was the subject of a French consensus conference recommending the use of amoxicillin-clavulanic acid and aminoglycoside [2]. In the context of emergence of resistant bacterial strains, iterative epidemiological studies are necessary to follow the evolution
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