Objective To study the major pathogens of the abdominal infection in children with acute appendicitis recently, and analyze the resistance of pathogens, combined with clinical efficacy, to learn about the spectrum of pathogens and sensitive antibacterial drugs, so as to guide rational use of antibacterial drugs. Methods Four hundred and ninety-three cases of pus specimens of acute appendicitis in children were tested by phoenix100 bacterial identification system for bacterial culture and sensitivity test, and the main types of pathogens and drug sensitivity were analyzed, and the treatment was followed up and the main pathogens and drug susceptibility spectrum were summarized. Results There were simple, suppurative and gangrenous appendicitis in this group, in which one single kind of bacte-rial infection in 1 case, 63 cases and 143 cases respectively; while two kinds in 0 case, 26 cases, and 62 cases respectively; and there was 1 case of gangrenous appendicitis with three kinds, though the comparison between pathological type appendicitis and bacterial infection type indicated that there was no significant difference(χ2=0.898, P>0.05). Four hundred and ninety-three cases of bacterial samples were detected with pathogens 296 cases, and the positive rate was 60.04%, 386 strains of bacteria were isolated, 341 strains(88.34%) of gram negative bacteria, 45 strains (11.66%) of gram positive bacteria; extended-spectrum β-lactamase producing strains were detected in total 126 strains(32.64%). The top three gram negative bacteria and gram positive bacteria were Escherichia coli(65.28%), Pseudomonas aeruginosa(12.18%), Comamonas testosteroni(5.44%)and Streptococcus anginosus(5.18%), Streptococcus constellatus(3.11%), Enterococcus raffinosus(0.78%), respectively.The sensitive rates of Escherichia coli, Pseudomonas aeruginosa, Comamonas testosteroni to Piperacillin/Tazobactam and Imipenem(tienam), Meropenem and Amikacin≥88.1%; the resistance rates of them to ampicillin, Tetracycline, Cotrimoxazole≥61.9%.The treatment program was Ceftizoxime sodium + Piperacillin/Tazobactam sodium + Metronidazole or Ornidazole. Conclusions The main pathogens are gram-negative bacteria in children appendicitis, and the most common bacteria is Escherichia coli, and it has significant resistance to the broad-spectrum Penicillins, Cephalosporins; In order to reduce the emergence of drug-resistance strains, germiculture and susceptibility test should be enhanced, use antibacterial drugs appropriately. Key words: Appendicitis; Child; Pathogens; Bacterial culture; Susceptibility test; Antibacterial drugs
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