Annals of Coloproctology

Original Article

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

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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
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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
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Aerobic Intraoperative Abdominal Cavity Culture Modifies Antibiotic Therapy and Reduces the Risk of Surgical Site Infection in Complicated Appendicitis with Peritonitis
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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
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Sorin Cimpean, Alberto Gonzalez Barranquero, Ion Surdeanu, Benjamin Cadiere, Guy-Bernard Cadiere
Annals of Coloproctology.2022;[Epub] CrossRef

Review

Benign GI diease,Epidemiology & etiology

A Review of Bowel Preparation Before Colorectal Surgery: Yeon Uk Ju, Byung Wook Min; Ann Coloproctol. 2021;37(2):75-84. Published online May 15, 2020; DOI: https://doi.org/10.3393/ac.2020.04.01

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Abstract PDF

Infectious complications are the biggest problem during bowel surgery, and one of the approaches to minimize them is the bowel cleaning method. It was expected that bowel cleaning could facilitate bowel manipulation as well as prevent infectious complications and further reduce anastomotic leakage. In the past, with the development of antibiotics, bowel cleaning and oral antibiotics (OA) were used together. However, with the success of emergency surgery and Enhanced Recovery After Surgery, bowel cleaning was not routinely performed. Consequently, bowel cleaning using OA was gradually no longer used. Recently, there have been reports that only bowel cleaning is not helpful in reducing infectious complications such as surgical site infection (SSI) compared to OA and bowel cleaning. Accordingly, in order to reduce SSI, guidelines are changing the trend of only intestinal cleaning. However, a consistent regimen has not yet been established, and there is still controversy depending on the location of the lesion and the surgical method. Moreover, complications such as Clostridium difficile infection have not been clearly analyzed. In the present review, we considered the overall bowel preparation trends and identified the areas that require further research.

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O. Zmora, Y. Stark, O. Belotserkovsky, M. Reichert, G. A. Kozloski, N. Wasserberg, H. Tulchinsky, L. Segev, A. J. Senagore, N. Emanuel
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Acta Médica Portuguesa.2022; 36(4): 254. CrossRef

Original Article

The Influence of Nutritional Assessment on the Outcome of Ostomy Takedown: Min Sang Kim, Ho Kun Kim, Dong Yi Kim, Jae Kyun Ju; J Korean Soc Coloproctol. 2012;28(3):145-151. Published online June 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.3.145

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32 Download
8 Citations

Abstract PDF

Purpose

Ostomy takedown is often considered a simple procedure without intention; however, it is associated with significant morbidity. This study is designed to evaluate factors predicting postoperative complications in the ostomy takedown in view of metabolism and nutrition.

Methods

A retrospective, institutional review-board-approved study was performed to identify all patients undergoing takedown of an ostomy from 2004 to 2010.

Results

Of all patients (150), 48 patients (32%; male, 31; female, 17) had complications. Takedown of an end-type ostomy showed a high complication rate; complications occurred in 55.9% of end-type ostomies and 15.7% of loop ostomies (P < 0.001). Severe adhesion was also related to a high rate of overall complication (41.3%) (P = 0.024). In preoperative work-up, ostomy type was not significantly associated with malnutrition status. However, postoperatively severe malnutrition level (albumin <2.8 mg/dL) was statistically significant in increasing the risk of complications (72.7%, P = 0.015). In particular, a significant postoperative decrease in albumin (>1.3 mg/dL) was associated with postoperative complications, particularly surgical site infection (SSI). Marked weight loss such as body mass index downgrading may be associated with the development of complications.

Conclusion

A temporary ostomy may not essentially result in severe malnutrition. However, a postoperative significant decrease in the albumin concentration is an independent risk factor for the development of SSI and complications.

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Farihazqa Hafez Mikala, Alpha Fardah Athiyyah, I Gusti Bagus Adria Hariastawa, I Gusti Made Reza Gunadi Ranuh
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Georgios Vasilopoulos, Panagiota Makrigianni, Maria Polikandrioti, Ilias Tsiampouris, Dimitrios Karayiannis, Nikoletta Margari, Lamprini Avramopoulou, Georgia Toulia, Georgia Fasoi
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