Caracteristiques microbiologiques des peritonites aigues generalisees au Centre hospitalier universitaire Souro Sanou de Bobo-Dioulasso

Abstract

L' objectif de notre etude etait de decrire les caracteristiques microbiologiques des peritonites aigues generalisees excepre les peritonites post-operatoires dans notre hOpital afin de proposer une antibiotherapie probabiliste. Nous avons realise une etude prospective de dix (10) mois qui a concerne tousles cas de peritonites aigues generalisees excepre les peritonites post-operatoires operees et ayant beneficie en per operatoire d'un prelevement de pus. Au total, 72 patients ont ere inclus avec une moyenne d'age de 27,3 ans avec des extremes de 14 mois et 67 ans. L' analyse des 72 echantillons de pus a permis de confirmer 39 cas dont 53 souches bacteriennes isolees ; il y avait une predominance des enterobacteries (58 %) suivi des cocci Gram positif (36 % ). Parmi les enterobacteries, E. coli etait de loin le plus frequent avec 47 %. Chez les cocci Gram positif, les streptocoques predominaient a 22 %. Dans notre serie, une sensibilire plus elevee des germes ala gentamicine, ala ceftriaxone eta la Ciprofloxacine a ere notee. Ces resultats  suggerent une antibiotherapie probabiliste des peritonites dans notre contexte associant les cephalosporines de troisieme generation (C3G) aux aminosides plus un imidazole pour couvrir eventuellement les anaerobies.

Mots-cles : peritonites, microbiologie, antibiotherapie.

Microbiological characteristics of generalized acute peritonitis at Souro Sanou teaching hospital of Bobo-Dioulasso

The objective of this study was to describe microbiological characteristics of  generalized acute peritonitis except the post-operatoire peritonitis in our hospital in order to propose a probabilistic antibiotic therapy. We realized a 10-month transversal prospective study, from July 1", 2012 till May 30'\ 2013.1t concerned all the cases of generalized acute peritonitis except the post-operatoire peritonitis operated and having benefited a taking of pus during surgery. Bacteriological analyses were realized according the protocol of treatment of pus in the laboratory. 72 patients were included. The mean age was of 27, 3 years with extremes of 14 months and 67 years. The analysis of 72 samples of pus allowed to confirm 39 cases and led to identification of 53 bacterial strains. The most common strains were enterobacteriaceae in 58.0%, gram-positive cocci in 36.0%. Escherichia coli  was the most common species (47%) followed by Streptococcus species (22% ). The microbiological confirmation of peritonitis was more frequent in the intervalle 20-30 years old. In our study, a higher  sensibility to gentamycin, ceftriaxon and Ciprofloxacin was noted. On the other hand amoxicillin just like clavulanic  acid-amoxicillin association showed a low activity on the isolates. These findings suggest a probability antibiotic treatment of the peritonitis in our context associating the third generation cephalosporin with aminosides more an imidazol to cover possibly the anaerobic.

Keywords: peritonitis, microbiology, antibiotherapy.