Zachos Konstantinos, Kolonitsiou Fevronia, Panagidis Antonios, Gkentzi Despoina, Fouzas Sotirios, Alexopoulos Vasileios, Kostopoulou Eirini, Roupakias Stylianos, Vervenioti Aggeliki, Dassios Theodore, Georgiou George, Sinopidis Xenophon
Department of Pediatric Surgery, Children's Hospital, 26331 Patras, Greece.
Department of Microbiology, University of Patras School of Medicine, 26504 Patras, Greece.
Diagnostics (Basel). 2023 May 24;13(11):1839. doi: 10.3390/diagnostics13111839.
Primary infection has been questioned as the pathogenetic cause of acute appendicitis. We attempted to identify the bacteria involved and to investigate if their species, types, or combinations affected the severity of acute appendicitis in children.
Samples from both the appendiceal lumen and the peritoneal cavity of 72 children who underwent appendectomy were collected to perform bacterial culture analysis. The outcomes were studied to identify if and how they were associated with the severity of the disease. Regression analysis was performed to identify any risk factors associated with complicated appendicitis.
, , and were the most common pathogens found in the study population. The same microorganisms, either combined or separate, were the most common in the appendiceal lumen and the peritoneal cavity of patients with complicated appendicitis. Gram-negative bacteria and polymicrobial cultures in the peritoneal fluid and in the appendiceal lumen were associated with complicated appendicitis. Polymicrobial cultures in the peritoneal cavity presented a four times higher risk of complicated appendicitis.
Polymicrobial presentation and Gram-negative bacteria are associated with complicated appendicitis. Antibiotic regimens should target the combinations of the most frequently identified pathogens, speculating the value of early antipseudomonal intervention.
原发性感染一直被质疑是急性阑尾炎的致病原因。我们试图确定其中涉及的细菌，并研究它们的种类、类型或组合是否会影响儿童急性阑尾炎的严重程度。
收集72例行阑尾切除术儿童的阑尾腔和腹腔样本进行细菌培养分析。研究结果以确定它们是否以及如何与疾病严重程度相关。进行回归分析以确定与复杂性阑尾炎相关的任何危险因素。
、 和 是研究人群中最常见的病原体。在复杂性阑尾炎患者的阑尾腔和腹腔中，相同的微生物，无论是组合还是单独存在，都是最常见的。腹腔液和阑尾腔中的革兰氏阴性菌和多种微生物培养与复杂性阑尾炎相关。腹腔中的多种微生物培养呈现出复杂性阑尾炎风险高四倍的情况。
多种微生物表现和革兰氏阴性菌与复杂性阑尾炎相关。抗生素治疗方案应针对最常鉴定出的病原体组合，推测早期抗假单胞菌干预的价值。
