Brook I
Ann Surg. 1980 Aug;192(2):208-12. doi: 10.1097/00000658-198008000-00014.
This study reports bacterial specimens obtained from 112 children presenting with a ruptured appendix. Additional samples were studied from 11 of these patients who developed a postoperative surgical draining wound. Bacterial growth occurred in 100 peritoneal fluid specimens. Anaerobic bacteria alone were present in 14 specimens, aerobes alone in 12, and mixed aerobic an anerobic flora in 74 specimens. There were 144 aerobic isolates (1.4 per specimen). The predominant isolates were: E. coli (57 specimens); alpha-hemolytic steptococcus (16 specimens); gamma-hemolytic streptococcus (15 specimens); Group D streptococcus (12 specimens); and P. aeruginosa (9 specimens). There were 301 anaerobic isolates (three per specimen). The predominant isolates were: 157 Bacteroides spp. (including 92 B. fragilis group and 26 B. melaninogenicus group); 62 gram-positive anaerobic cocci (including 30 Peptococcus sp.; 29 Peptostreptococcus sp.); 27 Fusobactenium sp.; and 16 Clostridium sp. B. fragilis and Peptococcus sp. occurred in 23 patients. Beta lactamase production was detectable in 98 isolates recovered from 74 patients. These included all isolates of B. fragilis and six of the 23 Bacteroides sp. Forty-nine organisms (16 aerobic and 33 anaerobic) were recovered from the draining wounds. The predominant organisms were: B. fragilis (8 specimens); E. coli (6 specimens); Peptostreptococcus sp. (5 specimens); and three specimens each of P. aeruginosa and Peptococcus sp. Most of these isolates were also recovered from the peritoneal cavity of the patients. These findings demonstrate the polymicrobial aerobic and anaerobic nature of peritoneal cavity and postoperative wound flora in children with perforated appendix, and demonstrate the presence of beta lactamase-producing organisms in three-fourths of the patients.
本研究报告了从112例阑尾破裂患儿获取的细菌标本。对其中11例出现术后手术引流伤口的患者的额外样本进行了研究。100份腹腔液标本中有细菌生长。仅厌氧菌存在于14份标本中，仅需氧菌存在于12份标本中，需氧菌和厌氧菌混合菌群存在于74份标本中。有144株需氧菌分离株（每份标本1.4株）。主要分离株为：大肠杆菌（57份标本）；α-溶血性链球菌（16份标本）；γ-溶血性链球菌（15份标本）；D组链球菌（12份标本）；以及铜绿假单胞菌（9份标本）。有301株厌氧菌分离株（每份标本3株）。主要分离株为：157株拟杆菌属（包括92株脆弱拟杆菌群和26株产黑色素拟杆菌群）；62株革兰氏阳性厌氧球菌（包括30株消化球菌属；29株消化链球菌属）；27株梭杆菌属；以及16株梭菌属。脆弱拟杆菌和消化球菌属出现在23例患者中。从74例患者中分离出的98株菌株可检测到β-内酰胺酶产生。这些包括所有脆弱拟杆菌分离株以及23株拟杆菌属中的6株。从引流伤口中分离出49株微生物（16株需氧菌和33株厌氧菌）。主要微生物为：脆弱拟杆菌（8份标本）；大肠杆菌（6份标本）；消化链球菌属（5份标本）；以及铜绿假单胞菌和消化球菌属各3份标本。这些分离株大多也从患者的腹腔中分离得到。这些发现证明了穿孔性阑尾炎患儿腹腔和术后伤口菌群的需氧菌和厌氧菌混合性质，并证明了四分之三的患者中存在产β-内酰胺酶的微生物。
