INTRODUCTION: Traditionally, microbiological swabs are taken for culture during appendicectomy. However, the pathogens encountered are largely predictable, and sensitive to broad-spectrum antibiotics. Thus, we aimed to examine the clinical value of this practice, by determining the influence of microbiological results on postoperative outcome in patients undergoing appendicectomy. PATIENTS AND METHODS: The study population comprised 721 consecutive patients undergoing appendicectomy for suspected acute appendicitis in a single district general hospital. Microbiological culture results and sensitivities of isolates were recorded in relation to histopathological findings and infective morbidity, to establish whether they influenced postoperative outcome. RESULTS: Swabs were taken during 463 (64%) appendicectomies. Only 113 (24%) yielded positive cultures ('coliforms', anaerobes and Streptococcus milleri were most frequently isolated). Organisms resistant to broad-spectrum antibiotics were encountered in only 11 of 463 patients (2%) where swabs were taken. Overall, 39 patients (5%) developed significant infective complications postoperatively. Neither the presence of a positive intra-operative culture, nor the isolation of resistant organisms were significant in predicting infective complications (P = 0.11 and 0.17, respectively). CONCLUSIONS: In the population studied, the results of intra-operative culture did not influence clinical outcome in patients undergoing appendicectomy. The practice of taking routine microbiological swabs for culture must be seriously questioned.
INTRODUCTION: Traditionally, microbiological swabs are taken for culture during appendicectomy. However, the pathogens encountered are largely predictable, and sensitive to broad-spectrum antibiotics. Thus, we aimed to examine the clinical value of this practice, by determining the influence of microbiological results on postoperative outcome in patients undergoing appendicectomy. PATIENTS AND METHODS: The study population comprised 721 consecutive patients undergoing appendicectomy for suspected acute appendicitis in a single district general hospital. Microbiological culture results and sensitivities of isolates were recorded in relation to histopathological findings and infective morbidity, to establish whether they influenced postoperative outcome. RESULTS: Swabs were taken during 463 (64%) appendicectomies. Only 113 (24%) yielded positive cultures ('coliforms', anaerobes and Streptococcus milleri were most frequently isolated). Organisms resistant to broad-spectrum antibiotics were encountered in only 11 of 463 patients (2%) where swabs were taken. Overall, 39 patients (5%) developed significant infective complications postoperatively. Neither the presence of a positive intra-operative culture, nor the isolation of resistant organisms were significant in predicting infective complications (P = 0.11 and 0.17, respectively). CONCLUSIONS: In the population studied, the results of intra-operative culture did not influence clinical outcome in patients undergoing appendicectomy. The practice of taking routine microbiological swabs for culture must be seriously questioned.
Authors: Alexander Reinisch; Patrizia Malkomes; Nils Habbe; Wolf Otto Bechstein; Juliane Liese Journal: Int J Colorectal Dis Date: 2017-07-15 Impact factor: 2.571
Authors: Massimo Sartelli; Dieter G Weber; Etienne Ruppé; Matteo Bassetti; Brian J Wright; Luca Ansaloni; Fausto Catena; Federico Coccolini; Fikri M Abu-Zidan; Raul Coimbra; Ernest E Moore; Frederick A Moore; Ronald V Maier; Jan J De Waele; Andrew W Kirkpatrick; Ewen A Griffiths; Christian Eckmann; Adrian J Brink; John E Mazuski; Addison K May; Rob G Sawyer; Dominik Mertz; Philippe Montravers; Anand Kumar; Jason A Roberts; Jean-Louis Vincent; Richard R Watkins; Warren Lowman; Brad Spellberg; Iain J Abbott; Abdulrashid Kayode Adesunkanmi; Sara Al-Dahir; Majdi N Al-Hasan; Ferdinando Agresta; Asma A Althani; Shamshul Ansari; Rashid Ansumana; Goran Augustin; Miklosh Bala; Zsolt J Balogh; Oussama Baraket; Aneel Bhangu; Marcelo A Beltrán; Michael Bernhard; Walter L Biffl; Marja A Boermeester; Stephen M Brecher; Jill R Cherry-Bukowiec; Otmar R Buyne; Miguel A Cainzos; Kelly A Cairns; Adrian Camacho-Ortiz; Sujith J Chandy; Asri Che Jusoh; Alain Chichom-Mefire; Caroline Colijn; Francesco Corcione; Yunfeng Cui; Daniel Curcio; Samir Delibegovic; Zaza Demetrashvili; Belinda De Simone; Sameer Dhingra; José J Diaz; Isidoro Di Carlo; Angel Dillip; Salomone Di Saverio; Michael P Doyle; Gereltuya Dorj; Agron Dogjani; Hervé Dupont; Soumitra R Eachempati; Mushira Abdulaziz Enani; Valery N Egiev; Mutasim M Elmangory; Paula Ferrada; Joseph R Fitchett; Gustavo P Fraga; Nathalie Guessennd; Helen Giamarellou; Wagih Ghnnam; George Gkiokas; Staphanie R Goldberg; Carlos Augusto Gomes; Harumi Gomi; Manuel Guzmán-Blanco; Mainul Haque; Sonja Hansen; Andreas Hecker; Wolfgang R Heizmann; Torsten Herzog; Adrien Montcho Hodonou; Suk-Kyung Hong; Reinhold Kafka-Ritsch; Lewis J Kaplan; Garima Kapoor; Aleksandar Karamarkovic; Martin G Kees; Jakub Kenig; Ronald Kiguba; Peter K Kim; Yoram Kluger; Vladimir Khokha; Kaoru Koike; Kenneth Y Y Kok; Victory Kong; Matthew C Knox; Kenji Inaba; Arda Isik; Katia Iskandar; Rao R Ivatury; Maurizio Labbate; Francesco M Labricciosa; Pierre-François Laterre; Rifat Latifi; Jae Gil Lee; Young Ran Lee; Marc Leone; Ari Leppaniemi; Yousheng Li; Stephen Y Liang; Tonny Loho; Marc Maegele; Sydney Malama; Hany E Marei; Ignacio Martin-Loeches; Sanjay Marwah; Amos Massele; Michael McFarlane; Renato Bessa Melo; Ionut Negoi; David P Nicolau; Carl Erik Nord; Richard Ofori-Asenso; AbdelKarim H Omari; Carlos A Ordonez; Mouaqit Ouadii; Gerson Alves Pereira Júnior; Diego Piazza; Guntars Pupelis; Timothy Miles Rawson; Miran Rems; Sandro Rizoli; Claudio Rocha; Boris Sakakushev; Miguel Sanchez-Garcia; Norio Sato; Helmut A Segovia Lohse; Gabriele Sganga; Boonying Siribumrungwong; Vishal G Shelat; Kjetil Soreide; Rodolfo Soto; Peep Talving; Jonathan V Tilsed; Jean-Francois Timsit; Gabriel Trueba; Ngo Tat Trung; Jan Ulrych; Harry van Goor; Andras Vereczkei; Ravinder S Vohra; Imtiaz Wani; Waldemar Uhl; Yonghong Xiao; Kuo-Ching Yuan; Sanoop K Zachariah; Jean-Ralph Zahar; Tanya L Zakrison; Antonio Corcione; Rita M Melotti; Claudio Viscoli; Perluigi Viale Journal: World J Emerg Surg Date: 2016-07-15 Impact factor: 5.469