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首页> 外文期刊>European journal of trauma and emergency surgery: official publication of the European Trauma Society >Uselessness of microbiological samples in acute appendicitis with frank pus: to collect or not to collect?
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Uselessness of microbiological samples in acute appendicitis with frank pus: to collect or not to collect?

机译：急性阑尾炎中微生物样品的无用性与Frank Pus：收集或不收集？

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Introduction Current use of antimicrobial therapy is prophylactic, empirical and broad spectrum. But, the age-old practice of obtaining cultures still remain. The aim of this study was to evaluate bacterial etiology and adequacy of antibiotic prophylaxis in patients diagnosed with acute appendicitis to help determine the utility of intraoperative cultures in guiding clinical decision-making. Materials and methods A retrospective analysis of a prospectively constructed database of all patients who underwent appendectomy from September 2013 to November 2016 was performed. Results 456 patients underwent surgery for acute appendicitis in our academic hospital. 101 patients (22.1%) had intraoperative swabs taken, and the cultures were positive in 57.4% of patients. These 101 patients comprise our study group. The most commonly recovered species wereE. coli, Streptococcusspp.,Bacteroides fragilis, Enterococcus faecium, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Proteus. In the comparison between positive and negative swab, there were no differences in terms of surgical site infection, deep infection, and in terms of Clavien-Dindo classification. An appropriate empiric therapy was set in 88.5% and inappropriate in 11.5%. No differences in terms of surgical site infection or in length of stay (p = 0.657) were found, with a median of 7 days in both groups. Conclusion The etiological agents causing peritonitis due to acute appendicitis are predictable and empiric-targeted antibiotic therapy is effective in a high percentage of patients. The postoperative patient outcome may be dependent on the severity of the appendicitis more than on the results of the swab at the time of surgery. In this study, intraoperative culture was not associated with the choice of antibiotics, incidence of SSI, DPI or the length of stay.
机译：引言目前使用抗菌治疗是预防性的，经验和广谱。但是，获得文化的古老惯例仍然存在。本研究的目的是评估患有急性阑尾炎的患者的抗生素预防的细菌病因和充分性，以帮助确定术中培养在指导临床决策中的效用。材料和方法对2013年9月至2016年11月的所有接受阑尾切除术的患者的前瞻性构建数据库的回顾性分析。结果456例患者在学术医院接受急性阑尾炎手术。 101名患者（22.1％）患有术中拭子，培养物为57.4％的患者阳性。这101名患者包含我们的研究组。最常见的恢复物种。 Coli，Streptococcusspp。，Brackoides fragilis，肠球菌粪便，假单胞菌铜绿假单胞菌，克莱布拉肺炎和蛋白质。在阳性和负拭子之间的比较中，手术部位感染，深入感染和克拉夫 - DINDO分类方面没有差异。适当的经验疗法设定在88.5％，不适合11.5％。发现外科部位感染或逗留时间（P = 0.657）没有差异，两组中位数为7天。结论导致急性阑尾炎引起腹膜炎的病因因子是可预测的，经验靶向抗生素治疗的高百分比患者有效。术后患者结果可能依赖于在手术时比棉签的结果的严重程度。在这项研究中，术中培养与抗生素的选择无关，SSI，DPI或逗留时间的选择。

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