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345513

The Importance of Intraoperative Culture Swabs for The Management of Patients With Complicated Appendicitis Who Undergoing Laparoscopic Appendectomy

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Last updated: 03 Jan 2025

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Abstract

Background: There is a controversy about the benefits of intraoperative culture swabs (IOCS) in appendectomy patients, some studies show no efficacy of such procedures while others support its use. Aim of the work: This study aimed to determine the epidemiological, clinical data, isolated microorganisms, and antibiotic resistance patterns in patients who underwent Laparoscopic appendectomy (LA) and evaluation of whether IOCS can modify the rate or management of post-appendectomy complications. Methods: the study was conducted on 292 patients who underwent laparoscopic appendectomy and intraoperative culture and sensitivity were done. Patients' electronic medical records were reviewed for the relevant demographic, perioperative, and postoperative data. Results: The most common isolated microorganisms were E coli 36.6%, and Klebsiella species 21.25% followed by Pseudomonas 8.33% which represents (21.27% and 5.18 % in complicated and non-complicated cases, respectively). Isolated Pseudomonas spp. and extended-spectrum beta-lactamase (ESBL) resistant Enterobacteriaceae were less frequently encountered (8.35%) but were resistant to most beta-lactam groups. Conclusion: 2nd generation cephalosporins and metronidazole were used as a first-line postoperative treatment in most uncomplicated cases. This treatment regimen was not effective against Pseudomonas spp and most ESBL-resistant strains. Quinolones were added to the regimen in complicated and severe cases, its use was reserved for complicated cases. A lower rate of complications was documented among studied patients in whom IOCS were used comparable to other studies' results. The treatment protocols were adjusted in a significant number of patients according to the result of IOCS, this reflects that its clinical implementation in routine surgical workup is clinically justified.  

DOI

10.21608/ejhm.2024.345513

Keywords

microbiology, Bacteria, swab, Laparoscopy, Appendicitis, Antibiotic resistance

Volume

94

Article Issue

1

Related Issue

45268

Issue Date

2024-01-01

Receive Date

2024-03-12

Publish Date

2024-01-01

Page Start

1,014

Page End

1,026

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_345513.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=345513

Order

152

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

The Importance of Intraoperative Culture Swabs for The Management of Patients With Complicated Appendicitis Who Undergoing Laparoscopic Appendectomy

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Article

Created At

24 Dec 2024