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The Microbiology of Community-acquired Peritonitis in Children

Dumont, Romain MD*; Cinotti, Raphaël MD*; Lejus, Corinne MD, PhD*; Caillon, Jocelyne MD, PhD†‡; Boutoille, David MD, PhD§; Roquilly, Antoine MD*; Podevin, Guillaume MD, PhD¶; Gras-Le Guen, Christelle MD, PhD‡∥; Asehnoune, Karim MD, PhD*‡

Pediatric Infectious Disease Journal: February 2011 - Volume 30 - Issue 2 - pp 131-135
doi: 10.1097/INF.0b013e3181eed7a4
Original Studies

Background: Microbiologic data are lacking regarding pediatric community-acquired peritonitis (CAP).

Methods: We conducted a 2-year retrospective single center study. Consecutive children undergoing CAP surgery were included. Microbiology and antimicrobial susceptibility of peritoneal isolates were analyzed.

Results: A total of 70 children from 3 months to 14 years of age were included. A total of 123 bacterial isolates were analyzed. Escherichia coli was the predominant aerobic organism (51% of isolates); 54.8% were susceptible to amoxicillin whereas 90.3% were susceptible to amoxicillin-clavulanate. Anaerobes accounted for 29% of isolates, and 94.3% of strains were susceptible to amoxicillin-clavulanate and 68.5% were susceptible to clindamycin. Pseudomonas aeruginosa was present in 6% of isolates and in 10% of children. The presence of E. coli resistant to amoxicillin or to amoxicillin-clavulanate was the only independent risk factor associated with postoperative peritonitis.

Conclusion: Microbiology of pediatric CAP is similar to adult CAP with a predominancy of E. coli and anaerobes. P. aeruginosa in peritoneal samples had no apparent influence on the outcome.

From the *CHU Nantes, Pôle Anesthésie-Réanimation, Service d'Anesthésie-Réanimation, Nantes, France; †CHU Nantes, Pôle de Biologie, laboratoire de Microbiologie, Nantes, France; ‡Université de Nantes, Faculté de médecine, Laboratoire UPRES EA 3826, Thérapeutiques cliniques et expérimentales des infections, Nantes, France; §CHU Nantes, Pôle Médecine-Oncologie-Hématologie, Service de médecine, Nantes, France; ¶CHU Nantes, Pôle Mère-enfant, Service de Chirurgie Infantile, Nantes, France; and ∥Pôle Mère-enfant, Service de Réanimation Pédiatrique et Néonatale, Nantes, France.

Accepted for publication June 25, 2010.

Supported by institutional and department sources.

Address for correspondence: Karim Asehnoune, MD, PhD, CHU de Nantes, Service d'Anesthésie-Réanimation, 1 place Alexis Ricordeau 44093 Nantes Cedex 1, France. E-mail: karim.asehnoune@chu-nantes.fr.

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© 2011 Lippincott Williams & Wilkins, Inc.