Association between bacterial resistance profile and the development of intra-abdominal abscesses in pediatric patients with perforated appendicitis: cohort study
Related Experiment Video
Updated: Jul 8, 2025
Growing a Cystic Fibrosis-Relevant Polymicrobial Biofilm to Probe Community Phenotypes
Published on: April 19, 2024
Luz Nélida Garzon-González1,2, Laura Tatiana Padilla2, Felipe Patiño3
1Paediatric Surgery Resident, Department of Surgery, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia.
Insights
This study found no link between antibiotic-resistant bacteria and intra-abdominal abscesses in children with perforated appendicitis. However, high-risk patients were more likely to develop this complication.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Microbiology
Background:
- Perforated appendicitis in children can lead to serious complications like intra-abdominal abscesses.
- Empirical antibiotic therapy is standard, but resistance patterns may influence outcomes.
- Understanding the role of microbial resistance is crucial for optimizing treatment strategies.
Purpose of the Study:
- To investigate the association between antibiotic-resistant microorganisms and the development of intra-abdominal abscesses in pediatric perforated appendicitis.
- To identify risk factors for postoperative intra-abdominal abscesses in this patient population.
Main Methods:
- Prospective cohort study of 232 children under 18 with perforated appendicitis undergoing laparoscopic appendectomy.
- Peritoneal fluid cultures were analyzed for bacterial identification and antibiotic resistance.
- Clinical data, including patient risk factors, were collected.
Main Results:
- Escherichia coli (80.14%) and Pseudomonas aeruginosa (7.45%) were the most common bacteria isolated.
- A low rate (5.31%) of extended-spectrum beta-lactamase (ESBL)-producing E. coli was observed.
- No significant association was found between resistant organisms and the development of intra-abdominal abscesses.
- High-risk patient status on admission was significantly associated with postoperative intra-abdominal abscesses (OR 2.89, p=0.01).
Conclusions:
- Antibiotic resistance did not correlate with increased risk of intra-abdominal abscesses in pediatric perforated appendicitis.
- Patient's high-risk status at admission is a key predictor of postoperative intra-abdominal abscesses.
- Focusing on identifying high-risk pediatric patients may improve outcomes and guide management strategies.
Purpose:
The objective of this study was to determine the association between the presence of a microorganism resistant to the antibiotic used in empirical therapy and the development of intra-abdominal abscesses in children with perforated appendicitis.
Methods:
A prospective cohort study was conducted in patients under 18 years of age who underwent laparoscopic appendectomy between November 1, 2019, and September 30, 2020, in whom perforated appendicitis was documented intraoperatively. Peritoneal fluid samples were taken for bacteria culture purposes, and clinical and microbiological data were collected from all patients.
Results:
A total of 232 patients were included in the study. The most isolated microorganisms were Escherichia coli (80.14%) and Pseudomonas aeruginosa (7.45%). In addition, 5.31% of E. coli isolates were classified as ESBL-producing organisms. No association was found between a germ resistant to empiric antimicrobial therapy and the development of a postoperative intra-abdominal abscess. Multivariate analysis showed that being a high-risk patient on admission (OR 2.89 (p = 0.01)) was associated with the development of intra-abdominal abscesses postoperatively.
Conclusion:
E. coli was the most commonly isolated microorganism, with a low rate of ESBL-producing isolates. No association between resistance and risk of postoperative intra-abdominal abscess was found. However, it was identified that being a high-risk patient on admission was associated with this complication.
Type Of Study:
Prognosis study.
Level Of Evidence:
Level I.
Related Concept Videos
01:22Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:31Defense Against Bacterial Pathogens
Phagocytes
Phagocytes are the frontline soldiers of the immune system. They include neutrophils and macrophages. Neutrophils are the most abundant type of white blood cell and are quickly mobilized to the site of infection. Macrophages are larger cells that patrol...