The bacteriological investigation with determining of the microflora nature enables a rational antibiotic therapy.
The aim of the research was to verify the specific composition according to the results of bacteriological investigation on appendix lumen and peritoneal extraction, and to analyze its sensitivity to antibiotics in patients with appendicular peritonitis.
Materials and methods. 356 hospital records of the patients with acute appendicitis were analyzed. Local sampling of biological material was conducted during the operation to perform microbiological investigations. The antibacterial efficiency of 33 antibiotics was investigated.
Results and discussion. High frequency of aerobic and anaerobic microbial associations and considerable identity of appendix and abdominal exudation microflora were confirmed. The positive result of bacteriological investigation of the pus from the abdominal cavity during appendicular peritonitis was collected in 44 (88.0%) patients. No flora growing was observed in 6 (12.0%) cases. The most efficient were gatifloxacin (100.0%), imipenem (86.1%), meropenem (85.7%).
Conclusions. Growing of Escherichia coli colonies in monoculture as well as in association with other bacteria, such as Staphylococcus aureus and Staphylococсus epidermidis (28.0%) was stated in 71.1% of cases. According to the results of investigations, appropriated bacterial cultures where sensitive to ftorxenolons, carbopenems and cefalosporines of the third generation and not sensitive to the antibacterial agents from the aminoglycosides, penicillin, glycopeptides, lincosamides, oxazolidones groups.
Matviichuk B.O., Kvit A.D., Terletskyi O.M., Tumochko M.I., Osinchuk O.I., Lutsushun V.I., Jakubovska M.O. Bacterial factors and ways to optimize the treatment program for the patients with acute appendicitis. Ukrainskyi Jurnal Khirurgii.2013; 1(20): 58-60.
Bezrodnyi B.G., Surmasheva O.V., Iovitsa A.V., Martunovych L.D., Moisejenko A.I. The choice of empirical antibiotic therapy in the surgical treatment of acute appendicitis destructive forms. Hirurgiia Ukrainu. 2011; 1: 17-22.
Khripun A.I., Shapovalyants S.G., Timofeev M.E., [et al.] Laparoscopies opportunities in the treatment of acute appendicitis. Endoscopicheskaya khirurgiya. 2006; 2: 147-148.
Zhuchenko O.P. The role of enteropatogen іnfection, local іmmunіty and autosensitization in pathogenesis of acute surgical abdominal diseases by the example of acute appendicitis. Klіnіchna khіrurgіia. 2004; 8: 19-21.
Kapustianskyi D.V. Antibiotic therapy in patients with acute appendicitis. Visnyk ukraiinskoii medychnoii stomatolohichnoii akademii. 2009; 4: 47-50.
Millenko V.I., Seregina M.V., Seregina V.V. The character of the microflora and its influence on the flowing of acute appendicitis, combined with gynecological pathology. Skoraya meditsunskaya pomoshch. 2004; 3: 45-48.
Mykhajlovych V.V. Microflora in patients with appendicular peritonitis. Ukrainskyi Zhurnal Hirurhii. 2009; 2: 99-100.
Mandate of the Ukrainian Ministry of Health “About approval of the clinical protocols of providing medical care in the speciality “Surgery” valid since 02.04.2010 p. №297. [Electronic resource]. http://www.moz. gov.ua/ua/portal/dn_20100402_297.html
Seregina M.V. Differential diagnosis and treatment tactics in patients with acute appendicitis in combination with gynecological pathology. Thesis. Ulyanovsk. 2007; 19.
Shapovalov V.Y. Technical features of laparoscopic appendectomy on destructive form of acute appendicitis. Clinicheskaya Khirurgiya. 2006; 3: 17-19.
Trifa M., Douiri H., Skhiri A., Blidi S., Ayeb H., Ghorbel S., Ben Khalifa S. Aerobic bacteria associated with acute appendicitis in children. Ann. Fr. Anesth. Reanim. 2009; 28 (1):24-27.
Andersson R.E. Therapy: Antibiotics or appendectomy for uncomplicated acute appendicitis? Nat Rev Gastroenterol Hepatol. 2012; 5 (9(7)): 370-371.
Varadhan K.K., Humes D.J., Neal K.R., Lobo D.N. Antibiotic therapy versus appendectomy for acute appendicitis: a meta-analysis. World J. Surg. 2010; 34(2): 199-209.
Lee S.L., Islam S., Cassidy L.D., Abdullah F., Arca M.J. Antibiotics and Appendicitis in the Pediatric Population: An American Pediatric Surgical Association Outcomes and Clinical Trials Committee Systematic Review. Journal of Pediatric Surgery. 2010; 45(11): 2181-2185.
Chen C.Y., Chen Y.C., Pu H.N., Tsai C.H., Chen W.T., Lin C.H. Bacteriology of acute appendicitis and its implication for the use of prophylactic antibiotics. Surgical Infections (Larchmt). 2012; 13(6): 383-390.
Hughes M.J. Harrison E., Paterson-Brown S. Post-operative antibiotics after appendectomy and post-operative abscess development: a retrospective analysis. Surgical Infections. 2013; 14(1):56-61.
Lamps L.W. Appendicitis and infections of the appendix. Semin. Diagn. Pathol. 2004; 21(2):86-97.
Guinanea C.M., Tadrousc A., Fouhy F., Ryan C.A., Dempsey E.M., Murphy B., Andrews E., Cotter P.D., Stanton C., Ross R.P. Microbial Composition of Human Appendices from Patients following. mBio. 2013; 4(1). Available at: http://mbio.asm.org/content/4/1/e00366.
Voiculescu D., Palade R. Immunologic and bacteriologic study of severe acute appendicitis. Diagnostics and therapeutic considerations. Chirurgia (Bucur). 2007; 102(3):271-276.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.