Bad bacteria in acute appendicitis: rare but relevant

Area of Science:

• Surgical infections
• Microbiology
• Infectious diseases

Background:

• Bacterial infections contribute to morbidity in acute appendicitis (AA).
• Multidrug-resistant (MDR) bacteria, particularly ESKAPE pathogens, pose a significant surgical challenge.
• Limited data exists on the specific resistances and their impact in AA.

Purpose of the Study:

• To analyze the prevalence and antibiotic resistance of bacteria in patients with AA.
• To compare microbiological findings in AA with those from alternative abdominal emergency surgeries (AES).
• To assess the impact of MDR bacteria on patient outcomes after laparoscopic appendectomy.

Main Methods:

• Retrospective analysis of microbiological swabs from AA patients.
• Evaluation of patient outcomes post-laparoscopic appendectomy correlated with microbiological results.
• Comparison of bacterial cultures from AA swabs with those from AES.

Main Results:

• In 584 AA patients, bacteria were cultivated in 59.3% of positive swabs, with Escherichia coli, Bacteroides, and Pseudomonas being most frequent.
• MDR bacteria, all identified as ESKAPE pathogens, were found in 9.4% of positive AA swabs.
• Patients with MDR bacteria experienced higher infectious complication rates and prolonged hospitalizations compared to those without.

Conclusions:

• MDR bacteria are present in acute appendicitis, contributing to increased patient morbidity.
• The prevalence of MDR bacteria in AA is lower than in emergency surgeries for other abdominal conditions.
• Antibiotic resistance testing and awareness are crucial for managing AA, even in common cases.