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Bacteriology of Peritonitis in Children Treated at the University Hospital of Marrakech

Received: 7 September 2019    Accepted: 24 September 2019    Published: 17 October 2019
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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.

Published in American Journal of Laboratory Medicine (Volume 4, Issue 5)
DOI 10.11648/j.ajlm.20190405.12
Page(s) 87-90
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Peritonitis, Antibiotherapy, Pediatrics

References
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[2] Société Française d’Anesthésie-Réanimation. Prise en charge des péritonites communautaires - conférence de consensus - texte court. Ann Fr Anesth Reanim 2001; 20: 368s-73s.
[3] 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.
[4] Mahamoudou Sanou, Armand Ky, Caractérisation de la flore bactérienne des péritonites communautaires opérées au Burkina Faso; The Pan African Medical Journal. 2014; 18: 17.
[5] Leone M, Boyadjiev I, Martin C. Péritonites communautaires: quelle antibiothérapie probabiliste? Urg Prat 2007; 80: 31-4.
[6] 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.
[7] 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.
[8] Montravers P, Jean-Baptiste S, Tashk P, Péritonites. Le Congrès. Médecins. Conférence d’Essentiel, 2016.
[9] 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.
[10] 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.
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[13] 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).
[14] 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.
[15] 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.
[16] 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.
[17] 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.
[18] Sartelli M. A focus on intra-abdominal infections. World J Emerg Surg 2010; 5: 2–20.
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  • APA Style

    Taoufik Rokni, Adil Rabi, Nabila Soraa, Hassan Ait Bahssain, Younous Said, et al. (2019). Bacteriology of Peritonitis in Children Treated at the University Hospital of Marrakech. American Journal of Laboratory Medicine, 4(5), 87-90. https://doi.org/10.11648/j.ajlm.20190405.12

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    ACS Style

    Taoufik Rokni; Adil Rabi; Nabila Soraa; Hassan Ait Bahssain; Younous Said, et al. Bacteriology of Peritonitis in Children Treated at the University Hospital of Marrakech. Am. J. Lab. Med. 2019, 4(5), 87-90. doi: 10.11648/j.ajlm.20190405.12

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    AMA Style

    Taoufik Rokni, Adil Rabi, Nabila Soraa, Hassan Ait Bahssain, Younous Said, et al. Bacteriology of Peritonitis in Children Treated at the University Hospital of Marrakech. Am J Lab Med. 2019;4(5):87-90. doi: 10.11648/j.ajlm.20190405.12

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  • @article{10.11648/j.ajlm.20190405.12,
      author = {Taoufik Rokni and Adil Rabi and Nabila Soraa and Hassan Ait Bahssain and Younous Said and Tarik Salama and Fouraiji Karima and Kamili El Ouafi El Aouni and Oulad Saiad Mohamed},
      title = {Bacteriology of Peritonitis in Children Treated at the University Hospital of Marrakech},
      journal = {American Journal of Laboratory Medicine},
      volume = {4},
      number = {5},
      pages = {87-90},
      doi = {10.11648/j.ajlm.20190405.12},
      url = {https://doi.org/10.11648/j.ajlm.20190405.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20190405.12},
      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.},
     year = {2019}
    }
    

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    T1  - Bacteriology of Peritonitis in Children Treated at the University Hospital of Marrakech
    AU  - Taoufik Rokni
    AU  - Adil Rabi
    AU  - Nabila Soraa
    AU  - Hassan Ait Bahssain
    AU  - Younous Said
    AU  - Tarik Salama
    AU  - Fouraiji Karima
    AU  - Kamili El Ouafi El Aouni
    AU  - Oulad Saiad Mohamed
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    DO  - 10.11648/j.ajlm.20190405.12
    T2  - American Journal of Laboratory Medicine
    JF  - American Journal of Laboratory Medicine
    JO  - American Journal of Laboratory Medicine
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    PB  - Science Publishing Group
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    AB  - 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.
    VL  - 4
    IS  - 5
    ER  - 

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Author Information
  • Department of Microbiology, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco

  • Department of Microbiology, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco

  • Department of Microbiology, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco

  • Department of Pediatric Anesthesia-reanimation, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco

  • Department of Pediatric Anesthesia-reanimation, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco

  • Department of Pediatric Anesthesia-reanimation, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco

  • Department of Pediatric Surgery, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco

  • Department of Pediatric Surgery, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco

  • Department of Pediatric Surgery, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco

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