Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Association of the Bacteria of the Vermiform Appendix and the Peritoneal Cavity with Complicated Acute Appendicitis in Children

Konstantinos Zachos
,
Fevronia Kolonitsiou
,
Antonios Panagidis
ORCID logo ,
Despoina Gkentzi
,
Sotirios Fouzas
ORCID logo ,
Vasileios Alexopoulos
,
Eirini Kostopoulou
ORCID logo ,
Stylianos Roupakias
,
Aggeliki Vervenioti
ORCID logo ,
Theodore Dassios
,
George Georgiou
,
Xenophon Sinopidis
* ORCID logo
Version 1 : Received: 25 April 2023 / Approved: 26 April 2023 / Online: 26 April 2023 (03:41:39 CEST)

A peer-reviewed article of this Preprint also exists.

Zachos, K.; Kolonitsiou, F.; Panagidis, A.; Gkentzi, D.; Fouzas, S.; Alexopoulos, V.; Kostopoulou, E.; Roupakias, S.; Vervenioti, A.; Dassios, T.; Georgiou, G.; Sinopidis, X. Association of the Bacteria of the Vermiform Appendix and the Peritoneal Cavity with Complicated Acute Appendicitis in Children. Diagnostics 2023, 13, 1839. Zachos, K.; Kolonitsiou, F.; Panagidis, A.; Gkentzi, D.; Fouzas, S.; Alexopoulos, V.; Kostopoulou, E.; Roupakias, S.; Vervenioti, A.; Dassios, T.; Georgiou, G.; Sinopidis, X. Association of the Bacteria of the Vermiform Appendix and the Peritoneal Cavity with Complicated Acute Appendicitis in Children. Diagnostics 2023, 13, 1839.

Abstract

Background: Primary infection has been questioned as the pathogenetic cause of acute appendicitis. We attempted to identify the bacteria involved, and to investigate if their species, types, or combinations affected the severity of acute appendicitis in children. Methods: Samples from both the appendiceal lumen and the peritoneal cavity of 72 children who underwent appendectomy were collected to perform bacterial culture analysis. The outcomes were studied to see if and how they were associated with the severity of the disease. Regression analysis was performed to identify any risk factors associated with complicated appendicitis. Results: Escherichia coli, Pseudomonas aeruginosa and Streptococcus species were the most common pathogens found in the study population. The same microorganisms, either combined or separate, were the most common in the appendiceal lumen and the peritoneal cavity of patients with complicated appendicitis. Gram-negative bacteria, polymicrobial cultures in the peritoneal fluid and in the appendiceal lumen, were associated with complicated appendicitis. Polymicrobial cultures in the peritoneal cavity presented four times higher risk of complicated appendicitis. Conclusion: Polymicrobial presentation and gram-negative bacteria are associated with complicated appendicitis. Antibiotic regimens should target the combinations of the most frequently identified pathogens, speculating the value of early antipseudomonal intervention.

Keywords

acute appendicitis; bacterial culture; children; appendiceal lumen; peritoneal cavity; complicated appendicitis

Subject

Medicine and Pharmacology, Pediatrics, Perinatology and Child Health

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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