Published online Nov 12, 2010.
https://doi.org/10.4174/jkss.2010.79.5.369
Bacteriologic Study and Antibiotics Sensitivity of Acute Appendicitis Treated with Laparoscopic Appendectomy
Abstract
Purpose
This study was designed to evaluate the bacteriological characteristics and antibiotics sensitivity in acute appendicitis.
Methods
The microbiologic culture and antibiotics sensitivity tests were done on 165 patients who underwent laparoscopic appendectomy under the diagnosis of acute appendicitis. The postoperative complications were also checked. The microbiologic and clinical results were compared between perforated and non-perforated groups.
Results
The most common organism cultured from the periappendiceal fluid was Escherichia coli (51.2%), followed by Enterobacter (16.2%) and Pseudomonas (8.9%). In the antibiotics sensitivity test, ciprofloxacin and levofloxacin were highly susceptible. Ceftriaxone and cefotaxime were also highly susceptible. Piperacillin/tazobactam, imipenem and meropenem were very highly susceptible. The complication rate of perforated appendicitis group (17.9%) was higher than that of the non-perforated appendicitis group (7.1%) (P<0.001). A surgical drain was used more frequently in perforated group (23% vs 84.6%, P<0.001). The mean in-patient days were longer in the perforated group (5.7 vs 7.2 days, P<0.001). In the patients with infectious wound complication, antibiotic resistance was more prominent in the non-perforated group than in the perforated group.
Conclusion
In the perforated appendicitis group, more precise and careful procedure was required. In the non-perforated appendicitis group, more prudent use of the available antibiotics to conserve valuable therapeutic resources and improved infection control to limit the spread of resistant organisms was required.
Table 1
Comparison of results between simple non-perforated and perforated/abscess appendicitis
Table 2
Microorganisms cultured from appendiceal tissue or peritoneal fluid
Table 3
The antibiotics sensitivity test of the microorganisms
Table 4
The antibiotics resistance of microorganisms
Table 5
Sensitivity and resistance of microorganisms cultured from appendicitis complications between non-perforated and perforated
References
-
Pieper R, Kager L, Nasman P. Acute appendicitis: a clinical study of 1018 cases of emergency appendectomy. Acta Chir Scand 1982;148:51–62.
-
-
Hopkins JA, Lee JC, Wilson SE. Susceptibility of intra-abdominal isolates at operation: a predictor of postoperative infection. Am Surg 1993;59:791–796.
-
-
Putnam TC, Gagliano N, Emmens RW. Appendicitis in children. Surg Gynecol Obstet 1990;170:527–532.
-
-
Park JB, Sul JY. Laparoscopic appendectomy: a safe primary procedure for complicated appendicitis. J Korean Surg Soc 2007;72:51–56.
-
-
Kooi GH, Pit S. Ceftazidime/metronidazole versus netilmicin/metronidazole in the treatment of perforated appendicitis in children. Clin Ther 1990;12:54–60.
-
-
Kim KJ, Jun HJ, Ryu JW, Park DG, Chung M, Kim JT, et al. A bacteriologic investigation of the acute appendicitis. J Korean Surg Soc 1997;52:122–127.
-
-
Yun SJ, Koh YT, Sim MS, Suh DY, Park DS. Culture-sensitivity test and infectious complication in perforated appendicitis. J Korean Soc Coloproctol 2000;16:73–77.
-
-
Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ, et al. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis 2010;50:133–164.
-
-
Park JM, Kim J, Kim CY, Choi DJ, Kim SH, Kim CS, et al. Laparoscopic appendectomy: a safe procedure that can be performed by surgical residents. J Korean Surg Soc 2008;75:315–322.
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