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Bacteriology of histopathologically defined appendicitis in children
M Rautio1, H Saxén, A Siitonen
1Anaerobe Reference Laboratory, National Public Health Institute, Helsinki, Finland. merja.rautio@ktl.fi
The Pediatric Infectious Disease Journal
|December 1, 2000
Summary
Childhood appendicitis microbiology is complex. Higher anaerobic bacteria counts, including Bilophila wadsworthia, are linked to gangrenous appendices in children, differing from adult findings.
Area of Science:
- Pediatric Surgery
- Microbiology
- Gastroenterology
Background:
- Acute appendicitis is the most common surgical emergency in childhood.
- The detailed pathogenesis and microbiology of childhood appendicitis remain unclear.
Purpose of the Study:
- To comprehensively investigate the bacterial etiology of appendicitis in children.
- To correlate the microbial findings with histologic tissue pathology.
Main Methods:
- Surgical tissue samples from 41 children with suspected appendicitis were analyzed.
- Histological examination and aerobic/anaerobic bacterial cultures were performed.
- Patients were categorized based on histopathologic and clinical findings.
Main Results:
- Bacterial species were isolated from 98% of samples, averaging 14.1 isolates per specimen.
- Gangrenous appendices showed significantly higher anaerobic isolates (11.7 vs. 7.7; P < 0.01).
- Key isolates included Bacteroides fragilis group (95%), Peptostreptococcus micros (66%), Bilophila wadsworthia (63%), Escherichia coli (88%), and Streptococcus anginosus group (61%).
Conclusions:
- Elevated anaerobic bacterial counts correlate with the progression from normal to gangrenous appendices in children.
- High frequencies of Bilophila wadsworthia and a novel bile-resistant Gram-negative rod in gangrenous appendices are unique pediatric findings.