Song DW, et al. - Researchers undertook an investigation of the microorganism of acute appendicitis and assessed the effective antibiotics among patients who underwent appendectomy for acute appendicitis. The use of empirical antibiotics was discovered to be safe in perforated appendicitis. The consideration of adequate antibiotics was recommended in some cases of Pseudomonas infection.

Methods

• The enrollment consisted of 694 subjects who underwent appendectomy for acute appendicitis and had positive microbial result between 2006 and 2015.
• Luminal contents of the appendix were swabbed after appendectomy for microbial analysis.
• Specimens were obtained from abscess fluid in patients with periappendiceal abscess.
• A retrospective appraisal was conducted of the patient characteristics, operative data, use of antibiotics, the results of microbiology, and postoperative morbidities including surgical site infection (SSI).

Results

• It was noted that the mean age of the participants was 38.2 (± 19.8) years, and 422 patients (60.8%) were male.
• Maximum operations were conducted via conventional laparoscopy (83.1%), followed by single-port laparoscopy (11.8%).
• As per the outcomes, the most common microorganism was Escherichia coli (64.6%), susceptible to amoxicillin/clavulanate, ciprofloxacin, most cephalosporins, piperacillin/tazobactam, and imipenem.
• Pseudomonas aeruginosa was the second most common microorganism (16.4%), which was resistant to amoxicillin/clavulanate and cefotaxime.
• It was discovered that the rate of postoperative morbidity was 8.6%, and the most common type was superficial SSI (6.2%), followed by ileus (1.2%), gastroenteritis (0.7%), and organ/space SSI (0.3%).
• The only prominent microorganism related to SSI was P. aeruginosa (odds ratio = 2.128, 95% confidence interval 1.077-4.206, P=0.030) revealed by multivariate analysis adjusting for other clinical factors.