Frequency of Bacterial Spectrum in Patients Presenting with Acute Appendicitis

Authors

  • Muhammad Abdullah
  • Muhammad Farhan Saeed
  • Mirza Sijeel Ahmad
  • Ibrahim Zafar Gondal
  • Ghazanfar Jabbar
  • Sajjad Dost

Keywords:

Appendicitis, Bacterial profile, C-reactive protein, Gram-negative bacteria, Appendectomy, E. Coli

Abstract

OBJECTIVE: To define the incidence of bacterial spectrum in individuals with acute appendicitis.

METHODOLOGY: This Descriptive cross-sectional study was conducted at the Department of Surgery, Pak Emirates Military Hospital, Rawalpindi, from November 2023 to April 2024. Statistics were obtained from individuals after written approval. A non-probability consecutive sampling technique was used. 145 Patients who presented with acute appendicitis were included. Non-consenting patients, patients with a history of tuberculosis, pneumonia, urinary tract infection and lower abdominal inflammatory conditions other than appendicitis were excluded. Numerical values were expressed as numbers, mean, and standard deviation and qualitative data were expressed as frequency and percentages. Outcome changers were measured by stratification to determine their efficacy, with a p-value of ?0.05 considered substantial. Statistics were analyzed on SPSS version 20

RESULTS: 145 individuals were involved. The mean age was 43.93±4.28 years. 83 (57.2%) were male and 62 (42.8%) were female. Out of 145 patients with acute appendicitis, the bacterial spectrum showed E. coli (34.5%), Staphylococcus aureus (5.5%), Pseudomonas aeruginosa (30.3%), Klebsiella pneumoniae (11%), Streptococcus (13.8%), Enterococcus saprophyticus (33.1%), and Bacteroides fragilis (38.6%).

CONCLUSION: The greater rate of isolation of pathogenic bacteria in patients with acute appendicitis supports its pathogenic role. Gram-negative microorganisms are most common in inflammation of the appendix, equating with gram-positive microorganisms.

References

Mán E, Simonka Z, Varga A, Rárosi F, Lázár G. Impact of the Alvarado score on the diagnosis of acute appendicitis: comparing clinical judgment, Alvarado score, and a new modified score in suspected appendicitis: a prospective, randomized clinical trial. Surg Endosc. 2014 Aug;28(8):2398-405.

Chen CY, Chen YC, Pu HN, Tsai CH, Chen WT et al. Bacteriology of acute appendicitis and its implication for the use of prophylactic antibiotics. Surg Infect (Larchmt) 2012;13:383–90.

Swidsinski A. Mucosal invasion by fusobacteria is a common feature of acute appendicitis in Germany, Russia, and China. Saudi J. Gastroenterol 2012 18:55–58

Naher HS, Ktab FK. Bacterial profile associated with appendicitis. Intern Res J Med Sci 2013;1(2):1-4.

Jeon HG, Ju HU, Kim GY, Jeong J, Kim MH, Jun JB. Bacteriology and changes in antibiotic susceptibility in adults with community-acquired perforated appendicitis. PLoS One. 2014 Oct 24;9(10):e111144.

Abid M. Bacteriology of Acute Appendicitis and its Implication for Rationale Use of Antibiotics. PJMHS. 2020; 14(3):

Zachos K, Kolonitsiou F, Panagidis A, Gkentzi D, Fouzas S, Alexopoulos V et al. Association of the Bacteria of the Vermiform Appendix and the Peritoneal Cavity with Complicated Acute Appendicitis in Children. Diagnostics. 2023; 13: 1839. https://doi.org/10.3390/diagnostics13111839

Maita S, Andersson B, Svensson JF. Non-operative treatment for nonperforated appendicitis in children: a systematic review and meta-analysis. Pediatr Surg Int. 2020; 36: 261–269. https://doi.org/10.1007/s00383-019-04610-1

Khaled AJ. Microbial Epidemiology of Acute and Perforated Appendicitis: A Post-Hoc Analysis of an EAST Multicenter Study. J Surg Res. 2020; 269: 69-75.

Kakar M, Reinis A, Kroica J, Engelis A, Broks R, Asare L et al. Microbiota Assessment of Pediatric Simple and Complex Acute Appendicitis. Medicina. 2022; 58: 1144

Hiroe K, Yonfan P, Kai S, Masaki Y, Akira H, Yukihiko K. Culture-based bacterial evaluation of the appendix lumen and antibiotic susceptibility of acute appendicitis in Japan: A single-center retrospective analysis. Medicine. 2020; 103(29): p e39037.

Tamura R, Nakamura K, Hirotani T. Differences in isolated bacteria between perforated and non-perforated appendicitis: an analysis of 680 consecutive appendicectomies in a single institution. Pediatr Surg Int. 2022; 38: 1887-1893.

Yukumi S, Ishimaru K, Suzuki H, Morimoto M, Sato C, Kaneko Y et al. Appropriate Antibiotic Selection during the in-hospital Waiting Period for Surgery for Appendicitis, J Anus Rectum Colon. 2022; 6(4): 259-263.

Laverde B, Maak M, Langheinrich M. The role of intraoperative swab during appendectomy in patients with uncomplicated and complicated appendicitis. Int J Colorectal Dis. 2023; 38: 272.

Jeon HG, Ju HU, Kim GY, Jeong J, Kim MH, Jun JB. Bacteriology and changes in antibiotic susceptibility in adults with community-acquired perforated appendicitis. PLoS One. 2014 Oct 24;9(10):e111144.

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Published

30-09-2025

How to Cite

1.
Muhammad Abdullah, Muhammad Farhan Saeed, Mirza Sijeel Ahmad, Ibrahim Zafar Gondal, Ghazanfar Jabbar, Sajjad Dost. Frequency of Bacterial Spectrum in Patients Presenting with Acute Appendicitis. J Liaq Uni Med Health Sci [Internet]. 2025 Sep. 30 [cited 2025 Oct. 13];24(03):308-11. Available from: http://121.52.154.205/index.php/jlumhs/article/view/1607