Does microbial resistance profile change in community-based intra-abdominal infections? Evaluation of the culture results of patients with appendicitis

Tartar, Tugay; Sağmak-Tartar, Ayşe; Saraç, Mehmet; Bakal, Ünal; Akbulut, Ayhan; Kazez, Ahmet

doi:10.24953/turkjped.2018.05.008

Cited by 5 publications

(3 citation statements)

References 16 publications

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“…Although underpowered, the results of this study showed that both hospital sites should focus on developing and testing targeted, interdisciplinary prevention efforts for E coli because this organism was found in almost half of the SSI cases (n = 9, 45%). This result is consistent with other studies on SSIs following abdominal surgery, showing E coli alone and in combination with other organisms such as Enterococcus species, Staphylococci , and Klebsiella 13,20,21 . Collaboration among health care workers is needed to discuss current protocols and to determine whether a single intervention (eg, alcohol‐based skin preparation, glycemic control for all patients during surgery, warming device to maintain perioperative normothermia, using an antimicrobial prophylaxis protocol to achieve bactericidal concentrations in serum and tissues during surgery) or a bundled approach would be most effective 16,17 .…”

Section: Discussionsupporting

confidence: 85%

Collecting Site‐Level Data on Organisms Causing Surgical Site Infections to Guide Quality Improvement

Goldman¹,

McAlister²,

Keith³

et al. 2021

AORN Journal

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Surgical site infections (SSIs) negatively affect patients and health care organizations. We conducted a descriptive, correlational study at two hospitals that provide care to rural patients in one Midwestern state. The study purposes were to describe: types of organisms causing reportable organ/space SSIs that occurred within 30 days of an open or a laparoscopic abdominal surgery (N = 20), and commonalities in patient‐ and care‐related factors to provide baseline information for site‐level prevention efforts for quality improvement. We identified Escherichia coli in almost half of the SSI cases (n = 9, 45%). Common patient‐related factors included ethnicity, smoking, and dirty or contaminated wounds. Common care‐related factors included longer surgery times (> 60 minutes), unplanned surgeries, and procedures that involved the colon or small bowel. Personnel can use site‐level data to monitor prevalent types of organisms causing SSIs, enabling an evidence‐based, interdisciplinary approach to develop and test methods to enhance prevention.

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Section: Discussionsupporting

confidence: 85%

Collecting Site‐Level Data on Organisms Causing Surgical Site Infections to Guide Quality Improvement

Goldman¹,

McAlister²,

Keith³

et al. 2021

AORN Journal

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“…To accomplish this discrimination, we searched MEDLINE via PubMed on Juli 15 th , 2022 for the name of the bacteria AND “human” AND “infection”. For rarely published bacteria, we set an arbitrary threshold at any bacteria with less than 0.3% of publications on human infections with E. coli , the most common bacteria in human appendicitis ( Wilms et al., 2011 ; Fallon et al., 2013 ; Kenig and Richter, 2013 ; Bhangu et al., 2015 ; Tartar et al., 2018 ; Son et al., 2020 ; Plattner et al., 2021 ).…”

Section: Methodsmentioning

confidence: 99%

Bacterial pathogens in pediatric appendicitis: a comprehensive retrospective study

Felber,

Gross,

Rahrisch

et al. 2023

Front. Cell. Infect. Microbiol.

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BackgroundAppendicitis is a frequent condition, with peak incidences in the second decade of life. Its pathogenesis is under debate, but bacterial infections are crucial, and antibiotic treatment remains essential. Rare bacteria are accused of causing complications, and various calculated antibiotics are propagated, yet there is no comprehensive microbiological analysis of pediatric appendicitis. Here we review different pre-analytic pathways, identify rare and common bacterial pathogens and their antibiotic resistances, correlate clinical courses, and evaluate standard calculated antibiotics in a large pediatric cohort.MethodWe reviewed 579 patient records and microbiological results of intraoperative swabs in standard Amies agar media or fluid samples after appendectomies for appendicitis between May 2011 and April 2019. Bacteria were cultured and identified via VITEK 2 or MALDI-TOF MS. Minimal inhibitory concentrations were reevaluated according to EUCAST 2022. Results were correlated to clinical courses.ResultsOf 579 analyzed patients, in 372 patients we got 1330 bacterial growths with resistograms. 1259 times, bacteria could be identified to species level. 102 different bacteria could be cultivated. 49% of catarrhal and 52% of phlegmonous appendices resulted in bacterial growth. In gangrenous appendicitis, only 38% remained sterile, while this number reduced to 4% after perforation. Many fluid samples remained sterile even when unsterile swabs had been taken simultaneously. 40 common enteral genera were responsible for 76.5% of bacterial identifications in 96.8% of patients. However, 69 rare bacteria were found in 187 patients without specifically elevated risk for complications.ConclusionAmies agar gel swabs performed superior to fluid samples and should be a standard in appendectomies. Even catarrhal appendices were only sterile in 51%, which is interesting in view of a possible viral cause. According to our resistograms, the best in vitro antibiotic was imipenem with 88.4% susceptible strains, followed by piperacillin-tazobactam, cefuroxime with metronidazole, and ampicillin-sulbactam to which only 21.6% of bacteria were susceptible. Bacterial growths and higher resistances correlate to an elevated risk of complications. Rare bacteria are found in many patients, but there is no specific consequence regarding antibiotic susceptibility, clinical course, or complications. Prospective, comprehensive studies are needed to further elicit pediatric appendicitis microbiology and antibiotic treatment.

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“…En nuestro estudio la mayoría de los niños con apendicitis presentan infección por E. coli (80.14%) 28,[33][34][35][36][37] . También encontramos que la prevalencia de P aeruginosa es del 7.45%, en la literatura se ha demostrado una prevalencia del 5.3% al 23% 35,[37][38][39] .…”

Section: Discussionunclassified

Updates on bacterial resistance and empirical antibiotics treatment of complicated acute appendicitis in children

Kwok

Tsui

Chan

2021

Journal of Pediatric Surgery

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Does microbial resistance profile change in community-based intra-abdominal infections? Evaluation of the culture results of patients with appendicitis

Abstract: Does microbial resistance profile change in community-based intra-abdominal infections? Evaluation of the culture results of patients with appendicitis.

Cited by 5 publications

References 16 publications

Collecting Site‐Level Data on Organisms Causing Surgical Site Infections to Guide Quality Improvement

Collecting Site‐Level Data on Organisms Causing Surgical Site Infections to Guide Quality Improvement

Bacterial pathogens in pediatric appendicitis: a comprehensive retrospective study

Updates on bacterial resistance and empirical antibiotics treatment of complicated acute appendicitis in children

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