Bacteriologic Study and Antibiotics Sensitivity of Acute Appendicitis Treated with Laparoscopic Appendectomy

Jae-Won Lee; Joong-Min Park; Seung-Eun Lee; Yong-Geum Park; Kyong-Choun Chi

doi:10.4174/jkss.2010.79.5.369

Journal List > J Korean Surg Soc > v.79(5) > 1011188

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Lee, Park, Lee, Park, and Chi: Bacteriologic Study and Antibiotics Sensitivity of Acute Appendicitis Treated with Laparoscopic Appendectomy

Original Article

Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2010; 79(5): 369-376.

Published online: 12 November 2010

DOI: https://doi.org/10.4174/jkss.2010.79.5.369

Bacteriologic Study and Antibiotics Sensitivity of Acute Appendicitis Treated with Laparoscopic Appendectomy

Jae-Won Lee, M.D., Joong-Min Park, M.D., Seung-Eun Lee, M.D., Yong-Geum Park, M.D., Kyong-Choun Chi, M.D.

Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea.

Corresponding author (jmpark@cau.ac.kr)

Received 29 April 2010 Accepted 16 September 2010

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.

Keywords: Appendicitis, Laparoscopic appendectomy, Microbiology, Antibiotics susceptibility test

Figures and Tables

Table 1

Comparison of results between simple non-perforated and perforated/abscess appendicitis

^*n = number of patients; ^†SD = standard deviation.

Table 2

Microorganisms cultured from appendiceal tissue or peritoneal fluid

^*Streptococcus = Streptococcus group G, Streptococcus not group A B C D F G; ^†Streptococcus = Streptococcus agalactiae, Streptococcus anginosus

Table 3

The antibiotics sensitivity test of the microorganisms

^*Amo/cla = amoxicillin/clavulanic acid; ^†Ampi/sulba = ampicillin/sulbactam; ^‡Tica/clav = ticarcillin/clavulanic acid; ^§Piper/tazo = piperacillin/tazobactam; ^∥Tri/sulfa = trimethoprim/sulfamethoxazole; ^¶ESBL = extended spectrum beta lactamase.

Table 4

The antibiotics resistance of microorganisms

Table 5

Sensitivity and resistance of microorganisms cultured from appendicitis complications between non-perforated and perforated

^*n = number of cultured bacteria; ^†Amo/cla = amoxicillin/clavulanic acid; ^‡Ampi/sulba = ampicillin/sulbactam; ^§Piper/tazo = piperacillin/tazobactam; ^∥Tri/sulfa = trimethoprim/sulfamethoxazole; ^¶ESBL = extended spectrum beta lactamase.

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