Annals of Coloproctology

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Benign GI diease

Routine Intraoperative Bacterial Culture May Be Needed in Complicated Appendicitis: Jung Tack Son, Gue Chun Lee, Hyung Ook Kim, Taewoon Kim, Donghyoun Lee, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim, Ho-Kyung Chun; Ann Coloproctol. 2020;36(3):155-162. Published online June 30, 2020; DOI: https://doi.org/10.3393/ac.2019.11.04.1

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Purpose
Choosing the appropriate antibiotic is important for treatment of complicated appendicitis. However, increasing multidrug resistant bacteria have been a serious problem for successful treatment. This study was designed to identify bacteria isolated from patients with complicated appendicitis and reveal their susceptibilities for antibiotics and their relationship with patient clinical course.
Methods
This study included patients diagnosed with complicated appendicitis and examined the bacterial cultures and antimicrobial susceptibilities of the isolates. Data were retrospectively collected from medical records of Kangbuk Samsung Hospital from January 2008 to February 2018.
Results
The common bacterial species cultured in complicated appendicitis were as follows: Escherichia coli (n=113, 48.9%), Streptococcus spp. (n=29, 12.6%), Pseudomonas spp. (n=23, 10.0%), Bacteriodes spp. (n=22, 9.5%), Klebsiella (n=11, 4.8%), and Enterococcus spp. (n=8, 3.5%). In antibiotics susceptibility testing, the positive rate of extended-spectrum beta lactamase (ESBL) was 9.1% (21 of 231). The resistance rate to carbapenem was 1.7% (4 of 231), while that to vancomycin was 0.4% (1 of 231). E. coli was 16.8% ESBL positive (19 of 113) and had 22.1% and 19.5% resistance rates to cefotaxime and ceftazidime, respectively. Inappropriate empirical antibiotic treatment (IEAT) occurred in 55 cases (31.8%) and was significantly related with organ/space surgical site infection (SSI) (7 of 55, P=0.005).
Conclusion
The rate of antibiotic resistance organisms was high in community-acquired complicated appendicitis in Koreans. Additionally, IEAT in complicated appendicitis may lead to increased rates of SSI. Routine intraoperative culture in patients with complicated appendicitis may be an effective strategy for appropriate antibiotic regimen.

Citations

Citations to this article as recorded by

Optimizing Antibiotic Management for Adult Patients Presenting with Acute Perforated Appendicitis: A Quality Improvement Study
Carlos Gallego-Navarro, Jason Beckermann, Maria E. Linnaus, Hayden J. Swartz, Shelby Stewart, Justin M. York, Ryan R. Gassner, Christopher A. Kasal, Annaliese G. Seidel, Corey J. Wachter, Kirstin J. Kooda, Jennifer R. Rich, Mark D. Sawyer
Surgical Infections.2025; 26(3): 143. CrossRef
A Prospective Analysis of the Burden of Multi-Drug-Resistant Pathogens in Acute Appendicitis and Their Implication for Clinical Management
Faruk Koca, Sara Fatima Faqar-Uz-Zaman, Claudia Reinheimer, Michael Hogardt, Volkhard A. J. Kempf, Paul Ziegler, Andreas A. Schnitzbauer, Armin Wiegering, Wolf Otto Bechstein, Patrizia Malkomes
Antibiotics.2025; 14(4): 378. CrossRef
Culture-based bacterial evaluation of the appendix lumen and antibiotic susceptibility of acute appendicitis in Japan: A single-center retrospective analysis
Hiroe Kitahara, Yonfan Park, Kai Seharada, Masaki Yoshimura, Akira Horiuchi, Yukihiko Karasawa
Medicine.2024; 103(29): e39037. CrossRef
Do Cultures From Percutaneously Drained Intra-abdominal Abscesses Change Treatment? A Retrospective Review
Andrew C. Esposito, Yuqi Zhang, Nupur Nagarkatti, William D. Laird, Nathan A. Coppersmith, Vikram Reddy, Ira Leeds, Anne Mongiu, Walter Longo, Ritche M. Hao, Haddon Pantel
Diseases of the Colon & Rectum.2023; 66(3): 451. CrossRef
Bacterial pathogens in pediatric appendicitis: a comprehensive retrospective study
Julia Felber, Benedikt Gross, Arend Rahrisch, Eric Waltersbacher, Evelyn Trips, Percy Schröttner, Guido Fitze, Jurek Schultz
Frontiers in Cellular and Infection Microbiology.2023;[Epub] CrossRef
An Update on Acute Appendicitis in Lebanon: Insights From a Single-Center Retrospective Study
Nagham Bazzi, Samer Dbouk, Ahmad Rached, Sadek Jaber, Hala Bazzi, Manal Jrad, Mariam Bazzi
Cureus.2023;[Epub] CrossRef
Bacterial peritonitis in paediatric appendicitis; microbial epidemiology and antimicrobial management
Keir Bhaskar, Simon Clarke, Luke S. P. Moore, Stephen Hughes
Annals of Clinical Microbiology and Antimicrobials.2023;[Epub] CrossRef
Aerobic Intraoperative Abdominal Cavity Culture Modifies Antibiotic Therapy and Reduces the Risk of Surgical Site Infection in Complicated Appendicitis with Peritonitis
Víctor Manuel Quintero-Riaza, Romario Chancí-Drago, Natalia Guzmán-Arango, Pablo Posada-Moreno, Tatiana López-Sandoval, Isabel Cristina Ramírez-Sánchez, Johanna Marcela Vanegas-Munera
Journal of Gastrointestinal Surgery.2023; 27(11): 2563. CrossRef
Does the Covid-19 pandemic have an effect on wound culture in patients undergoing appendectomy? A Case Control Study
Hacı BOLAT, Tuğba AVAN MUTLU
Journal of Contemporary Medicine.2022; 12(2): 332. CrossRef
Are We Hitting the Target?
Julia Elrod, Fatima Yarmal, Christoph Mohr, Martin Dennebaum, Michael Boettcher, Deirdre Vincent, Konrad Reinshagen, Ingo Koenigs
Pediatric Infectious Disease Journal.2022; 41(6): 460. CrossRef
Is Routine Intra-operative Gram Stain, Culture, and Sensitivity during an Appendectomy is Effective in Decreasing the Rate of Post-operative Infective Complications?
Muqdad Fuad, Ahmed Modher, Mohammed Habash
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Die Bedeutung mikrobiologischer Ergebnisse für die Therapie der komplizierten Appendizitis – eine monozentrische Fall-Kontroll-Studie
F-X. Anzinger, K. Rothe, S. Reischl, C. Stöss, A. Novotny, D. Wilhelm, H. Friess, P-A. Neumann
Die Chirurgie.2022; 93(10): 986. CrossRef
Implications of bacteriological study in complicated and uncomplicated acute appendicitis
Sorin Cimpean, Alberto Gonzalez Barranquero, Ion Surdeanu, Benjamin Cadiere, Guy-Bernard Cadiere
Annals of Coloproctology.2022;[Epub] CrossRef

A Clinical Comparison of Laparoscopic versus Open Appendectomy for Complicated Appendicitis: Sun Gu Lim, Eun Jung Ahn, Seong Yup Kim, Il Yong Chung, Jong-Min Park, Sei Hyeog Park, Kyoung Woo Choi; J Korean Soc Coloproctol. 2011;27(6):293-297. Published online December 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.6.293

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24 Citations

Abstract PDF

Purpose

Although laparoscopic appendectomies (LAs) are performed universally, a controversy still exists whether the LA is an appropriate surgical approach to complicated appendicitis (CA). We retrospectively evaluated the outcomes of laparoscopic versus open appendectomies for CA.

Methods

We retrospectively analyzed 60 consecutive patients who were diagnosed as having CA from July 2009 to January 2011. Outcomes such as operative time, time to soft diet, length of hospital stay, and postoperative complications were analyzed.

Results

There were no statistically significant differences in operative time between the LA and the open appendectomy (OA) groups. Return to soft diet was faster in the LA group (2.1 ± 1.2 vs. 3.5 ± 1.5 days; P = 0.001). Length of hospital stay was shorter for the LA group (4.4 ± 2.3 vs. 5.8 ± 2.9 days; P = 0.045). The overall complication rates showed no statistically significant difference between the two groups. In cases involving a periappendiceal abscess, the LA had a significantly higher incidence of intra-abdominal abscess (IAA) and postoperative ileus (PI; P = 0.028).

Conclusion

The LA showed good results in terms of the time to soft diet, the length of hospital stay, and surgical site infection (SSI) whereas the overall complication rates were similar for the two groups. However, the LA was associated with significantly higher incidence of IAA and PI for the cases with a periappendiceal abscess. Therefore, when using a LA, the surgeon must take great care to minimize the incidence of IAA and PI if a periappendiceal abscess is present.

Citations

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Risk factors for developing intra-abdominal abscess following appendicectomy for acute appendicitis: a retrospective cohort study
B P Mao, G Collins, F E Ayeni, D J Vagg
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The outcomes of laparoscopic versus open appendectomies for complicated appendicitis
Ahmed A. Sabry, Mahmoud Menesy, Mohamed Kassem, Mostafa R. Elkeleny
The Egyptian Journal of Surgery.2023; 42(3): 736. CrossRef
Intra and Postoperative Advantages of Laparoscopy in the Treatment of Complicated Appendicitis
Andrej Nikolovski, Cemal Ulusoy
PRILOZI.2022; 43(2): 59. CrossRef
AAn Evaluation of the Choice of the Treatment for the Acute Appendicitis An Original Research
Srikanth N. Jarupla, Ganesh Vadthya, Mushtaq A. Chowdhary, Heena D. Tiwari, Pritee R. Pandey, Afroz K. Syed, Akriti Mahajan
Journal of Pharmacy and Bioallied Sciences.2022; 14(Suppl 1): S188. CrossRef
Predictors for prolonged length of stay after laparoscopic appendectomy for complicated acute appendicitis in adults
Aleix Martínez-Pérez, Carmen Payá-Llorente, Sandra Santarrufina-Martínez, Juan Carlos Sebastián-Tomás, Elías Martínez-López, Nicola de’Angelis
Surgical Endoscopy.2021; 35(7): 3628. CrossRef
A clinical comparison of laparoscopic versus open appendectomy for the treatment of complicated appendicitis: historical cohort study
Tomoya Takami, Tomoyuki Yamaguchi, Hiroyuki Yoshitake, Kotaro Hatano, Naoki Kataoka, Masafumi Tomita, Shinichiro Makimoto
European Journal of Trauma and Emergency Surgery.2020; 46(4): 847. CrossRef
Laparoscopic versus open appendectomy for perforated appendicitis in adults: randomized clinical trial
Ahmed Talha, Hany El-Haddad, Abd-Elhamid Ghazal, Gihan Shehata
Surgical Endoscopy.2020; 34(2): 907. CrossRef
The Bucharest ESTES consensus statement on peritonitis
Bogdan Diaconescu, Selman Uranues, Abe Fingerhut, Mihaela Vartic, Mauro Zago, Hayato Kurihara, Rifat Latifi, Dorin Popa, Ari Leppäniemi, Jonathan Tilsed, Matei Bratu, Mircea Beuran
European Journal of Trauma and Emergency Surgery.2020; 46(5): 1005. CrossRef
Complications after Laparoscopic Appendectomy for Complicated Appendicitis
Andrej Nikolovski, Shenol Tahir, Dragoslav Mladenovikj
Lietuvos chirurgija.2020; 19(1-2): 34. CrossRef
Irrigation Versus Suction in Laparoscopic Appendectomy for Complicated Appendicitis: A Meta-analysis
Charalampos Siotos, Konstantinos Stergios, Vishnu Prasath, Stella M. Seal, Mark D. Duncan, Joseph V. Sakran, Mehran Habibi
Journal of Surgical Research.2019; 235: 237. CrossRef
Laparoscopic appendicectomy is superior to open surgery for complicated appendicitis
Gaik S. Quah, Guy D. Eslick, Michael R. Cox
Surgical Endoscopy.2019; 33(7): 2072. CrossRef
Comparison of clinical outcome of laparoscopic versus open appendectomy, single center experience
Mitsugi Shimoda, Tsunehiko Maruyama, Kiyotaka Nishida, Kazuomi Suzuki, Tomoya Tago, Jiro Shimazaki, Shuji Suzuki
Heliyon.2018; 4(5): e00635. CrossRef
Systematic Review and Meta‐Analysis of Laparoscopic Versus Open Appendicectomy in Adults with Complicated Appendicitis: an Update of the Literature
Christos Athanasiou, Sonia Lockwood, Georgios A. Markides
World Journal of Surgery.2017; 41(12): 3083. CrossRef
Comparison of clinical outcome of laparoscopic versus open appendectomy for complicated appendicitis
P. Horvath, J. Lange, R. Bachmann, F. Struller, A. Königsrainer, M. Zdichavsky
Surgical Endoscopy.2017; 31(1): 199. CrossRef
Laparoscopic Appendectomy Using Hem-o-lok Polymer Clips: A Single-Center Experience
Bahadır Öz, Ertan Emek, Muhammet Akyüz, Erdoğan Sözüer, Türkmen Arıkan, Alper Akcan, Hızır Akyıldız
International Surgery.2017; 102(7-8): 334. CrossRef
Treatment Modalities and Antimicrobial Stewardship Initiatives in the Management of Intra-Abdominal Infections
Charles Hoffmann, Matthew Zak, Lisa Avery, Jack Brown
Antibiotics.2016; 5(1): 11. CrossRef
Laparoscopic versus open surgery for complicated appendicitis in adults: a randomized controlled trial
Yoshiro Taguchi, Shunichiro Komatsu, Eiji Sakamoto, Shinji Norimizu, Yuji Shingu, Hiroshi Hasegawa
Surgical Endoscopy.2016; 30(5): 1705. CrossRef
Laparoscopic versus open approach in the management of appendicitis complicated exclusively with peritonitis: A single center experience
Felipe Quezada, Nicolas Quezada, Ricardo Mejia, Alejandro Brañes, Oslando Padilla, Nicolas Jarufe, Fernando Pimentel
International Journal of Surgery.2015; 13: 80. CrossRef
Are There Specific Indications for Laparoscopic Appendectomy? A Review and Critical Appraisal of the Literature
Dorin Popa, Marek Soltes, Selman Uranues, Abe Fingerhut
Journal of Laparoendoscopic & Advanced Surgical Techniques.2015; 25(11): 897. CrossRef
Is laparoscopy a safe approach for diffuse appendicular peritonitis? Feasibility and determination of risk factors for post-operative intra-abdominal abscess
Jérémie Thereaux, Nicolas Veyrie, Nicola Corigliano, Stéphane Servajean, Sébastien Czernichow, Jean-Luc Bouillot
Surgical Endoscopy.2014; 28(6): 1908. CrossRef
Research and Science Today Supplement 1/2014
Flavius Marcau, Elena Steluta Dinu, Roxana Elena Dobritoiu, Raul Constantin Tanase, Alina Buzaianu, Andreea-Emilia Duta, Ion Panait, Paul Duta, Magda Simona Scutaru, Nicolaie Manescu, Dragos Davitoiu, Laura Manda, Florin Chirculescu, Diana Epure, Margarit
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Same-day Surgery for Laparoscopic Appendectomy in Appendicitis: Is this Safe?
Wirt Cross, Gopal Chandru Kowdley
The American Surgeon™.2014; 80(1): 25. CrossRef
Comparison of Clinical Outcomes after Laparoscopic and Open Appendectomy for Complicated Appendicitis
Jong Min Kim, Sung Ryol Lee, Hyung Ook Kim, Won Joon Choi, Byung Ho Son
The Journal of Minimally Invasive Surgery.2013; 16(4): 98. CrossRef
A Study of Laparoscopic Appendectomy
Yo MIZUKAMI, Shuichi OTA, Atsushi HARADA, Masatoshi AKAGAMI, Takuya INOMOTO, Yukito ADACHI
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2013; 74(6): 1423. CrossRef

Diagnostic Value of C-reactive Protein in Complicated Appendicitis: Hyoung-Min Moon, Beom-Seok Park, Duk-Jin Moon; J Korean Soc Coloproctol. 2011;27(3):122-126. Published online June 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.3.122

5,813 View
49 Download
23 Citations

Abstract PDF

Purpose

Early detection of appendicitis has increased due to development of computed tomography and ultrasonography, yet we are frequently meeting complicated appendicitis, including perforation, abscess and a gangrenous appendicitis due to delayed diagnosis. For that reason, we want to evaluate predictive factors for the complicated appendicitis.

Methods

A total of 128 patients with appendicitis, after 13 patients with a duration of under 12 hours and 15 patients with pathological non-appendicitis were excluded from 156 patients, who visited Kwangju Christian Hospital from November 2008 to November 2010 were retrospectively reviewed.

Results

There were 62 patients (48.3%) with simple appendicitis and 66 patients (51.7%) with complicated appendicitis. In univariate analysis, age (P < 0.001), C-reactive protein (P < 0.001) and the diameter of the appendix (P = 0.006), were found to be significant. Multivariate analysis demonstrated that C-reactive protein was an independent predictor for complicated appendicitis (odds ratio, 1.371; 95% confidence interval, 1.155 to 1.628; P < 0.001). The cut-off value of C-reactive protein was set at 7.05 mg/dL by using receiver operating characteristic curve (0.805; sensitivity, 57.6%; specificity, 98.3%).

Conclusion

This study suggests that if C-reactive protein is above 7.05 mg/dL, immediate and proper management should be performed due to a high probability of complicated appendicitis, especially in young children or elderly patients who frequently present with vague symptoms.

Citations

Citations to this article as recorded by

Clinical prediction model for gangrenous appendicitis: A retrospective single-center study
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Usefulness of extended inflammatory parameters related to neutrophil activation reported by Sysmex XN-1000 hematology analyzer for predicting complicated acute appendicitis. Comparison with canonical inflammatory laboratory tests
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Usefulness of extended inflammatory parameters related to neutrophil activation reported by Sysmex XN-1000 hematology analyzer for predicting complicated acute appendicitis. Comparison with canonical inflammatory laboratory tests
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Cirugía Española.2024; 102(6): 300. CrossRef
A Case-control Study on the Correlation between Serum Bilirubin Levels and Various Types of Appendicitis
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