• IMA sites
  • IMAJ services
  • IMA journals
  • Follow us
  • Alternate Text Alternate Text
עמוד בית
Sun, 08.12.24

ORIGINALS

IMAJ | volume 26

Journal 6, June 2024
pages: 355-360

Incidence, Predictors, and Outcomes of Pseudomonas aeruginosa Associated Acute Appendicitis in Children

1 Pediatric Infectious Diseases Unit, Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel 2 Department of Pediatric Surgery, Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel 3 Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel 4 Department of Pediatrics, Bnai Zion Medical Center, Haifa, Israel 5 Department of Family Medicine, Maccabi Healthcare Services, Hod HaSharon, Israel 6 Department of Pediatrics, Ziv Medical Center, Safed, Israel 7 Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel

Summary

Background:

Pseudomonas aeruginosa (PSA) is an infectious pathogen associated with acute appendicitis; however, it is not consistently addressed by empirical antibiotic therapy, despite potential complications.

Objectives:

To investigate the incidence, predictors, and outcomes of PSA-associated acute appendicitis in children.

Methods:

We conducted a retrospective analysis involving pediatric patients who underwent acute appendicitis surgery and had positive peritoneal cultures. Clinical, microbiological, and intraoperative data were extracted from medical records.

Results:

Among 2523 children with acute appendicitis, 798 (31.6%) underwent peritoneal cultures, revealing 338 positive cases (42.3%), with PSA detected in 77 cases (22.8%). Children with PSA were three times more likely to exhibit high intraoperative grading ≥ 3 (93.4% vs. 76.8%, 95% confidence interval [95%CI] 1.2–8.3, P = 0.023) and nearly four times more likely to have polymicrobial cultures (88.3% vs. 62.1%, 95%CI 1.8–8.0, P < 0.001) than those without PSA in peritoneal cultures. Duration of symptoms did not predict PSA isolation (P = 0.827). Patients with PSA had longer median hospital stays (8 days, interquartile range [IQR] 7–10) than those with other pathogens (7 days, IQR 5–9) (P = 0.004). Antibiotic treatment duration, intensive care unit admission rates, readmission, and mortality were similar between the two groups (P = 0.893, 0.197, 0.760, and 0.761, respectively).

Conclusions:

PSA is a common pathogen in children diagnosed with acute appendicitis and positive peritoneal cultures. The likelihood of isolating PSA increases with high-grade intraoperative assessment and in the presence of multiple pathogens in peritoneal cultures, suggests antipseudomonal treatment.

Legal Disclaimer: The information contained in this website is provided for informational purposes only, and should not be construed as legal or medical advice on any matter.
The IMA is not responsible for and expressly disclaims liability for damages of any kind arising from the use of or reliance on information contained within the site.
© All rights to information on this site are reserved and are the property of the Israeli Medical Association. Privacy policy

2 Twin Towers, 35 Jabotinsky, POB 4292, Ramat Gan 5251108 Israel