Microbial Epidemiology of Acute and Perforated Appendicitis: A Post-Hoc Analysis of an EAST Multicenter Study

Jawad, Khaled Abdul; Qian, Sinong; Vasileiou, Georgia; Larentzakis, Andreas; Rattan, Rishi; Dodgion, Christopher; Kaafarani, Haytham M.A.; Zielinski, Martin D.; Namias, Nicholas; Yeh, D. Dante

doi:10.1016/j.jss.2021.07.026

Cited by 5 publications

(5 citation statements)

References 23 publications

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“…More recent studies comparing bacterial cultures between patients with perforated and non-perforated appendicitis reported analogous outcomes. E. coli was the most common microorganism both in acute and perforated appendicitis irrespective of the clinical presentation, a finding encountered in our study population as well [53,54]. Though noncorrelated directly with complications, it presented extended spectrum β-lactamase production [53].…”

Section: Discussionmentioning

confidence: 55%

Association of the Bacteria of the Vermiform Appendix and the Peritoneal Cavity with Complicated Acute Appendicitis in Children

Zachos¹,

Kolonitsiou

Panagidis³

et al. 2023

Diagnostics

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Background: Primary infection has been questioned as the pathogenetic cause of acute appendicitis. We attempted to identify the bacteria involved and to investigate if their species, types, or combinations affected the severity of acute appendicitis in children. Methods: Samples from both the appendiceal lumen and the peritoneal cavity of 72 children who underwent appendectomy were collected to perform bacterial culture analysis. The outcomes were studied to identify if and how they were associated with the severity of the disease. Regression analysis was performed to identify any risk factors associated with complicated appendicitis. Results: Escherichia coli, Pseudomonas aeruginosa, and Streptococcus species were the most common pathogens found in the study population. The same microorganisms, either combined or separate, were the most common in the appendiceal lumen and the peritoneal cavity of patients with complicated appendicitis. Gram-negative bacteria and polymicrobial cultures in the peritoneal fluid and in the appendiceal lumen were associated with complicated appendicitis. Polymicrobial cultures in the peritoneal cavity presented a four times higher risk of complicated appendicitis. Conclusions: Polymicrobial presentation and Gram-negative bacteria are associated with complicated appendicitis. Antibiotic regimens should target the combinations of the most frequently identified pathogens, speculating the value of early antipseudomonal intervention.

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Section: Discussionmentioning

confidence: 55%

Association of the Bacteria of the Vermiform Appendix and the Peritoneal Cavity with Complicated Acute Appendicitis in Children

Zachos¹,

Kolonitsiou

Panagidis³

et al. 2023

Diagnostics

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“…Surprisingly, in spite of the intense inflammatory response caused by COVID-19, the cut-off point turned out to be 2.63 -lower than that established for the diagnosis of appendicitis in our study (3.98). This could be explained by the viral etiology of COVID-19 and the fact its immune response is primarily lymphocytic, whereas in acute appendicitis, there is often a local infectious component involving the intestinal bacterial flora (19,20) . In this very study, NLR had a better AUC than dNLR, but the latter showed greater sensitivity and negative likelihood ratio.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of cell ratios and the derived neutrophil-to-lymphocyte ratio in the diagnosis of pediatric acute appendicitis

Moreno Alfonso,

Molina Caballero,

Pérez Martínez

2024

Cir Pediatr

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Objective. To analyze the accuracy of cell ratios in the diagnosis of pediatric acute appendicitis while introducing a new one -the derived neutrophil-to-lymphocyte ratio (dNLR).Materials and methods. An observational, retrospective study of patients aged 0-15 years old diagnosed with acute appendicitis (AA) and with non-surgical abdominal pain (AP) treated in our institution from 2021 to 2022 was carried out. The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and dNLR were compared between groups.Results. 98 AA patients (30% of whom were female; age: 10 ± 3.3 years) and 97 AP patients (53% of whom were male; age: 9.3 ± 3.7 years) were included. NLR, MLR, PLR, and dNLR values were higher in AA patients than in AP patients: 9.6 IQR (interquartile range) 9.

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“…Since the bacteria of acute appendicitis infection are mostly Escherichia coli [ 17 ], patients were treated with a third-generation cephalosporin antibiotic after surgery. All patients received the same antibiotic treatment.…”

Section: Methodsmentioning

confidence: 99%

Application and curative effect of laparoscopic purse-string sutures in the treatment of adult acute complicated appendicitis

et al. 2023

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Objective To investigate the effect of laparoscopic purse-string sutures in adult complicated appendicitis treatment. Methods The data of 568 adult cases of complicated appendicitis treated by laparoscopic appendectomy at the Hefei Second People’s Hospital, Anhui Province, China, from September 2018 to September 2021 were analysed retrospectively. The patients were divided into two groups: 295 cases in the laparoscopic purse-string suture treatment group (observation group) and 273 cases in the simple Hem-o-lok® clamp treatment group (control group). The baseline data collected included age, gender, preoperative body temperature, leukocyte count and percentage of neutrophils and the surgery time. The postoperative data collected included antibiotic treatment duration, drainage tube placement time and the incidence of complications. Results There were no significant differences in the baseline data of the two groups, including age, gender, preoperative body temperature, leukocyte count and neutrophil percentage (all P > 0.05). Compared with the control group, the postoperative hospital length of stay, duration of antibiotic treatment, the recovery time of peripheral white blood cell and neutrophil counts and the incidence of postoperative complications in the observation group were significantly decreased (P < 0.05). Conclusion Purse-string sutures can effectively reduce the incidence of postoperative complications after a laparoscopic appendectomy for adult acute complicated appendicitis. There was faster postoperative recovery when patients’ appendiceal stumps were treated with laparoscopic purse-string sutures.

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Microbial Epidemiology of Acute and Perforated Appendicitis: A Post-Hoc Analysis of an EAST Multicenter Study

Cited by 5 publications

References 23 publications

Association of the Bacteria of the Vermiform Appendix and the Peritoneal Cavity with Complicated Acute Appendicitis in Children

Association of the Bacteria of the Vermiform Appendix and the Peritoneal Cavity with Complicated Acute Appendicitis in Children

Usefulness of cell ratios and the derived neutrophil-to-lymphocyte ratio in the diagnosis of pediatric acute appendicitis

Application and curative effect of laparoscopic purse-string sutures in the treatment of adult acute complicated appendicitis

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