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Published on: March 10, 2020
Bacteriological profile of community peritonitis operated in a Moroccan Hospital
Samia Bazhar1,2, Elmostafa Benaissa1,2, Fatima Ziad1,2
1Department of Clinical Bacteriology, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco.
Abstract:
Introduction. Peritonitis is characterized by acute inflammation of the peritoneum, often resulting from digestive organ perforation or intra-abdominal septic focus. It may be of either infectious or non-infectious origin. The bacteria involved are those of the digestive flora (Enterobacteriaceae and anaerobes), while Gram-positive cocci and yeasts can be isolated in nosocomial infections. Our study aims to isolate and identify the germs involved in community-acquired peritonitis in order to assess their susceptibility to the antibiotics available in our country. Methods. This is a retrospective study of the bacteriological profile of community peritonitis in Rabat Morocco. A total of 150 adult patients with peritonitis were admitted and samples were collected intraoperatively for bacteriological examination between 1 July 2022 and 30 April 2023. Results. Among the 150 patients, 101 (67.8%) were males and 49 (32.2%) were females, with a sex ratio (M/F) of 2 : 1. The mean age of the patients was 40.5 years±20.12. The distribution of bacteria was dominated by Escherichia coli (44%). Overall, 70% of E. coli isolated exhibited resistance to ampicillin, whereas no resistance to ampicillin has been reported for Enterococcus. Discussion. In the present study, we were interested in the bacteriological profile of community peritonitis in order to adapt the antibiotic therapy to our bacterial ecology. Our findings indicate a concerning trend of increasing resistance among E. coli to the commonly used amoxicillin/clavulanic acid combination in our clinical setting. Conclusion. Consequently, there is a need to reassess the empiric antibiotic prescribed for the management of community-acquired peritonitis.
Insights
Community-acquired peritonitis in Morocco shows high resistance of Escherichia coli to ampicillin. This highlights the urgent need to reassess empiric antibiotic choices for effective treatment.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Clinical Pharmacy
Background:
- Peritonitis, an acute inflammation of the peritoneum, often stems from digestive organ perforation or intra-abdominal sepsis.
- Bacterial peritonitis commonly involves digestive flora like Enterobacteriaceae and anaerobes, with Gram-positive cocci and yeasts seen in nosocomial infections.
- Understanding the local bacteriology is crucial for effective antibiotic therapy in community-acquired peritonitis.
Purpose of the Study:
- To isolate and identify the specific microorganisms causing community-acquired peritonitis in Rabat, Morocco.
- To evaluate the antibiotic susceptibility patterns of these isolated pathogens.
- To inform and adapt empirical antibiotic treatment strategies based on local bacterial ecology and resistance trends.
Main Methods:
- A retrospective study analyzing the bacteriological profile of 150 adult patients with community peritonitis.
- Intraoperative samples were collected for bacteriological examination over a 10-month period (July 2022 - April 2023).
- Data on patient demographics and isolated bacterial species, along with their antibiotic resistance profiles, were analyzed.
Main Results:
- Escherichia coli was the predominant bacterium, isolated in 44% of cases.
- A significant finding was the 70% resistance rate of E. coli to ampicillin.
- Enterococcus species, in contrast, showed no ampicillin resistance in this study cohort.
Conclusions:
- The study reveals a concerning increase in resistance among E. coli to commonly prescribed antibiotics like amoxicillin/clavulanic acid.
- There is a critical need to re-evaluate and potentially revise the empirical antibiotic regimens for community-acquired peritonitis in this region.
- Local antibiotic susceptibility data are essential for optimizing treatment outcomes and combating antimicrobial resistance.
