Microbiota Assessment of Pediatric Simple and Complex Acute Appendicitis
<b>Background and Objectives</b>. The aim of this study is to determine the prevailing microbiota in samples from pediatric patients with acute appendicitis, as well as evaluate the antibacterial sensitivity of the isolated microorganisms, comparing the data obtained with the clinic’s an...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-08-01
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| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/58/9/1144 |
| Summary: | <b>Background and Objectives</b>. The aim of this study is to determine the prevailing microbiota in samples from pediatric patients with acute appendicitis, as well as evaluate the antibacterial sensitivity of the isolated microorganisms, comparing the data obtained with the clinic’s antibacterial therapy guidelines. <b>Materials and Methods</b>. The study group consisted of 93 patients between the ages of 7 and 18. All patients underwent a laparoscopic or conventional appendectomy. The children were hospitalized with signs and symptoms suggestive of acute appendicitis. Microbiological cultures from the appendix and abdominal cavity were collected intraoperatively. <b>Results</b>. <i>E. coli</i> was identified in most cases irrespective of the clinical presentation of acute appendicitis. Most strains were susceptible to ampicillin and amoxicillin/clavulanic acid. Five strains of <i>E. coli</i> produced extended spectrum beta-lactamase (ESBL). <i>Pseudomonas aeruginosa</i> (<i>P. aeruginosa</i>) was the second most commonly isolated causative agent. Furthermore, it was common in cases of acute complex appendicitis. Most strains of <i>P. aeruginosa</i> were resistant to amoxicillin/clavulanic acid, ertapenem, ampicillin and cefotaxime, yet were susceptible to ceftazidime. Regardless of the clinical presentation, the samples yielded mixed isolates. <b>Conclusion</b>. <i>E. coli</i> is the main causative agent of acute appendicitis in the pediatric population displaying susceptibility to various antibiotics. <i>P. aeruginosa</i> was more prevalent in cases of acute complex appendicitis. <i>P. aeruginosa</i> isolates were susceptible to ceftazidime; however, they were resistant to cefotaxime, which should, therefore, be removed from guidelines for empirical antibacterial treatment of acute appendicitis due to phenotypic resistance of <i>P. aeruginosa</i>. We recommend antibiotics with distinct implementation to avoid antibiotic resistance. |
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| ISSN: | 1010-660X 1648-9144 |