儿童社区获得性腹膜炎的微生物学。

The Microbiology of Community-acquired Peritonitis in Children.

机构信息

CHU Nantes, Pôle Anesthésie-Réanimation, Service d'Anesthésie-Réanimation, Nantes, France.

出版信息

Pediatr Infect Dis J. 2011 Feb;30(2):131-5. doi: 10.1097/INF.0b013e3181eed7a4.

DOI:10.1097/INF.0b013e3181eed7a4

PMID:20664490

Abstract

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.

摘要

背景

儿科社区获得性腹膜炎（CAP）的微生物学数据尚缺乏。

方法

我们进行了一项为期 2 年的回顾性单中心研究。纳入接受 CAP 手术的连续儿童。分析腹膜分离株的微生物学和抗菌药物敏感性。

结果

共纳入 3 个月至 14 岁的 70 例儿童。共分析了 123 株细菌分离株。大肠埃希菌是主要需氧菌（51%的分离株）；对阿莫西林的药敏率为 54.8%，对阿莫西林-克拉维酸的药敏率为 90.3%。厌氧菌占分离株的 29%，对阿莫西林-克拉维酸的药敏率为 94.3%，克林霉素的药敏率为 68.5%。6%的分离株和 10%的患儿存在铜绿假单胞菌。对阿莫西林或阿莫西林-克拉维酸耐药的大肠埃希菌的存在是与术后腹膜炎相关的唯一独立危险因素。