Bacterial Profile and Sensitivity in Adults Post Appendectomy for Acute Complicated Appendicitis

Moshwana MR, Mamathuntsha TG, Koto MZ, Mabitsela M and Mthelebofu B

Department of General Surgery, Sefako Makgatho Health Sciences University, South Africa

^*Correspondance to: Mdumo Rupert Moshwana 

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Abstract:

Background: Acute appendicitis, a significant abdominal surgical emergency, presents diagnostic and management challenges and often results in complications. This study investigated microbial pathogens and antibiotic sensitivity patterns in complicated acute appendicitis to provide essential insights for targeted antimicrobial therapy. Methods: This retrospective cross-sectional review at Dr. George Mukhari Academic Hospital included 52 culture-positive cases of complicated acute appendicitis diagnosed between October 2021 and October 2022. Demographics, clinical presentations, diagnostic methods, operative procedures, and outcomes were analyzed. Microbial pathogens, antibiotic sensitivity, and resistance patterns were examined. Results: Escherichia coli (E. coli) emerged as the predominant organism as a single isolate and mixed with other pathogens at 82.69% (n=43), displaying varying sensitivities to antibiotics. Other cultures included Streptococcus species, Klebsiella species, and Pseudomonas, in descending order. E. coli showed sensitivity rates of 97%, 70%, and 60% to gentamycin, cefuroxime, and amoxycillin/ clavulanic acid, respectively. Gram-positive organisms, including Streptococcus and Enterococcus spp., were prevalent, whereas Pseudomonas aeruginosa was prominent among gram-negative organisms. Surgical site infection occurred in 21% of the cases, underscoring the importance of appropriate antibiotic treatment. This study identified significant antibiotic resistance, particularly in penicillin’s, sulfonamides, cephalosporins, and quinolones. Conclusion: This study offers crucial insights into the microbial landscape of complicated acute appendicitis and emphasizes the prevalence of antimicrobial resistance. Escherichia coli dominated, and antibiotic sensitivity patterns underscored the need for cautious drug usage. These findings contribute to refining treatment protocols and highlight the urgency of ongoing surveillance to combat the rising challenges of antimicrobial resistance in complicated acute appendicitis.

Keywords:

Complicated Appendicitis; Escherichia coli; Antimicrobial Resistance; Surgical Site Infections; Antibiotic Sensitivity

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