DOI: https://doi.org/10.36347/sjmcr.2026.v14i04.035

Pages: 732-738

Introduction: Pediatric intra-abdominal infections (IAIs) are a common surgical emergency associated with significant morbidity, particularly in developing countries. Their polymorphic clinical presentation makes diagnosis challenging, while their polymicrobial nature complicates management. Early initiation of broad-spectrum empirical antibiotic therapy is essential and should be adapted according to bacteriological findings and local microbial ecology. However, the emergence of antimicrobial resistance increasingly limits treatment effectiveness. Data on the bacteriological profile of pediatric IAIs remain scarce, hindering the development of clear guidelines. This study aims to identify the causative pathogens and evaluate their antibiotic susceptibility to optimize therapeutic strategies. Materials and Methods: A retrospective descriptive study was conducted over four years (2020–2023) in a pediatric surgery department, including children aged 1 month to 15 years treated for community-acquired intra-abdominal infections. Neonates and healthcare-associated infections were excluded. Data were collected from medical, surgical, and microbiology records. All patients underwent surgical management with systematic intraoperative sampling for bacteriological analysis. Microbiological assessment included Gram staining, aerobic and anaerobic cultures, and bacterial identification using biochemical methods or MALDI-TOF mass spectrometry. Statistical analysis was performed using descriptive methods, and associations between pathogens and resistance profiles were evaluated using Fisher’s exact test, with significance set at p < 0.05. Results: A total of 471 patients were included, with a mean age of 8.9 years and a male predominance (66.5%). Appendicular peritonitis was the most frequent diagnosis (80.7%), followed by intra-abdominal abscesses (17.6%), with good concordance between admission and intraoperative findings. Empirical antibiotic therapy consisted predominantly of