1015. INCREASED PREVALENCE OF STREP SPECIES IN COMPLICATED APPENDICITIS: ONE INSTITUTION EXPERIENCE
Session: Poster Abstract Session: Enteric Infection
Friday, October 9, 2015
Room: Poster Hall
Posters
  • Appendicitis Poster 2015.jpg (291.6 kB)
  • Background: Appendicitis is the most common cause of intra-abdominal infection and surgical intervention in children with a higher incidence in adolescents and young adults. Intra-abdominal abscesses were more frequently observed in perforated appendicitis than in non-perforated appendicitis. The pathogens from the normal enteric flora are involved in the pathology of intra-abdominal infections; often poly-microbial (74%) in nature they include both aerobic and anaerobic strains. Objective of this study is to analyze the bacteriological etiology of complicated appendicitis in pediatric population.

    Methods: A retrospective chart review of patients with acute and complicated appendicitis was conducted between May 2009 and March 2014. All patients between the ages of 0 to 18 yrs with clinical or radiographic diagnosis of acute appendicitis were included. Demographic data and microbiological data of peritoneal fluid were collected. Patients with acute appendicitis with perforation, peritonitis, abscess, and gangrenous appendicitis were included in the complicated appendicitis (CAp) group. Patients with mucosal, transmural and/or periappendicitis were included in the uncomplicated appendicitis (UAp) group. Statistical analysis was performed using Chi-Square test.

    Results: A total of 385 patients (58% male) were identified, 287 patients were classified as UAp and 98 (25.4%) as CAp. Peak incidence of CAp (72%) observed in 0-5 years age group. Forty six percent of the CAp cases were culture positive for different streptococcus in which alpha hemolytic strep non group D (51% of streptococcal positive) and streptococcus milleri were predominant strains. Streptococcus group was found in significantly higher number (p<0.001) in CAp compared to E coli (p<0.018). Eighty percent of these streptococcal culture positive cases were associated with appediceal abscess formation. Ten percent of CAp patients had post-operative intra-abdominal abscess and 60% of those were positive for streptococcus milleri.

    Conclusion: Children with CAp showed increased incidence (p<0.001) of alpha hemolytic non group D streptococcus and streptococcus milleri infections then E coli (p<0.018). Majority (80%) of strep positive events were associated with abscess formation.

    Renuka Verma, MD, Pediatrics, Unterberg Children's Hospital at Monmouth Medical Center, Long Branch, NJ, Rituparna Deb, MD, Pediatrics, Monmouth Medical Center, Long Branch, NJ and Ian Thomas Cohen, MS, Surgery, Monmouth Medical Center, Long Branch, NJ

    Disclosures:

    R. Verma, None

    R. Deb, None

    I. T. Cohen, None

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