A Clinical Study on Appendix Bacterial Flora in Pediatric Acute Appendicitis

Hirotani Taichi, Abe Takatoshi, Hayashi Kengo, Shimotake Takashi

doi:10.11164/jjsps.52.4_917

Purpose: At present, conservative therapies of nonperforated appendicitis or mass-forming appendicitis are being tried. On the other hand, postoperative pseudomembranous enterocolitis and resistant bacteria such as extended-spectrum beta-lactamase (ESBL)-producing E. coli are also problems. Appendiceal bacterial flora (ABF) might affect the clinical course of pediatric acute appendicitis. In this study, we aimed to show the association between ABF and clinical presentation.<br> Methods: ABF was retrospectively investigated in 275 children (149 boys and 126 girls; aged 2 to 15 years) who underwent appendectomy for acute appendicitis in our hospital between January 2007 and December 2014. The content fluid was collected from the removed appendix; then, aerobic and anaerobic bacterial cultures were examined. In perforated cases, purulent ascites were also examined.<br> Results: E. coli was found in 203 (73.8%) patients, and five of them carried ESBL-producing E. coli. Bacteroides (56.4%), Streptococcus (29.1%), Enterococcus (17.5%), and Pseudomonas (13.5%) were also isolated. Furthermore, Yersinia enterocolitica was detected in one (0.4%) patient.<br> Conclusion: ABF seemed not to be directly involved in the pathogenesis of acute appendicitis; however, ABF analysis not only reveals the pathogenic bacteria themselves, but also provides much information based on which postoperative infection, resistant bacterial induction, and pseudomembranous enterocolitis are prevented.

A Clinical Study on Appendix Bacterial Flora in Pediatric Acute Appendicitis

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