Lau W Y, Teoh-Chan C H, Fan S T, Yam W C, Lau K F, Wong S H
Ann Surg. 1984 Nov;200(5):576-81. doi: 10.1097/00000658-198411000-00003.
A detailed bacteriologic study was done on 161 patients operated for appendicitis. Aerobic and anaerobic cultures were taken from the blood, the appendicular lumen, mucosa, serosa, fossa, and from the wound after closure of the peritoneum. There is no correlation between the degree of appendicitis and the incidence of positive blood culture. The infection spread through the appendicular wall as the disease progressed. Aerobic infection was common in early appendicitis but a mixed aerobic and anaerobic infection was predominant in late cases. Late appendicitis, a positive wound culture at the end of the operation, the duration of symptoms of over 36 hours before operation and the age of the patient over 50 years were all associated with an increased incidence of septic complication. From the antibiotic sensitivity on the bacteria isolated, the most effective agent against anaerobes was metronidazole. Effective agents against the aerobes were aminoglycosides and cephalosporins. The best single agent against both anaerobes and aerobes was moxalactum.
对161例接受阑尾炎手术的患者进行了详细的细菌学研究。从血液、阑尾腔、黏膜、浆膜、隐窝以及腹膜关闭后的伤口处采集需氧和厌氧培养样本。阑尾炎的严重程度与血培养阳性率之间无相关性。随着病情进展，感染通过阑尾壁扩散。早期阑尾炎以需氧菌感染常见，但晚期病例以需氧菌和厌氧菌混合感染为主。晚期阑尾炎、手术结束时伤口培养阳性、术前症状持续超过36小时以及患者年龄超过50岁均与脓毒症并发症发生率增加相关。从分离出的细菌的抗生素敏感性来看，对厌氧菌最有效的药物是甲硝唑。对需氧菌有效的药物是氨基糖苷类和头孢菌素。对厌氧菌和需氧菌均有效的最佳单一药物是羟羧氧酰胺菌素。
