Type and antibiotic susceptibility of bacteria cultured in paediatric acute appendicitis

Studying the microbial profile and their antibiotic resistance in paediatric appendicitis is essential for tracking susceptibility, guiding treatment choices and ensuring effectiveness. Understanding variations in therapies can improve outcomes and reduce complications. Despite its importance, limited research has been conducted in South Africa on microbial profiles and antibiotic resistance in paediatric appendicitis.

To identify bacteria cultured from pus specimens obtained from paediatric patients with acute appendicitis and determine their antibiotic susceptibility.

This was a prospective case series of children aged 13 years and younger, who had appendectomies for acute appendicitis. Data were collected via REDCap and analysed using R software. Pus swabs were obtained for microscopy, culture and sensitivity of organisms isolated.

The study comprised 20 patients, of whom 12 (60%) were male. Most cases (n = 17; 85%) were complicated appendicitis. Escherichia coli was the most prevalent bacterial species isolated, accounting for 60% of cases, while no bacterial growth was observed in 30% of cases. All the isolates (100%) were susceptible to cefepime, gentamicin, amikacin, ertapenem, imipenem and meropenem, while high sensitivity rates of 92.9% were found for ciprofloxacin, ceftazidime and piperacillin-tazobactam. Short-term complications (predominantly surgical site infections) were present in 6 patients (30%).

Escherichia coli was the most common bacterium in paediatric acute appendicitis, with all isolates sensitive to ciprofloxacin.

Regional monitoring and research are useful to adapt protocols and combat increasing antibiotic resistance.