title: Does noncomplicated acute appendicitis cause bacterial translocation?
abstract: It is unknown whether noncomplicated acute appendicitis cause bacterial translocation. In this study, we aimed to test development of the bacterial translocation in the patients who were operated for acute appendicitis. In this prospective study, 10 control patients who underwent elective operations because of other reasons, and 18 patients with noncomplicated acute appendicitis were evaluated. No patients took prophylactic antibiotic. After laparotomy, samples were obtained from peritoneal leaf just close to wound edge, and peritoneal swab culture from right paracolic region. Before appendectomy, a mesenteric lymph node (MLN) adjacent to the terminal ileum was taken out. Tissue samples were placed in a sterile container for microbiological analysis, and 10% formalin for histopathological analysis. Control samples had no bacterial translocation. Only 3 of 18 (16.6%) patients with appendicitis included bacterial translocation to MLN. There was no significant difference between both groups. No bacterial colonization was detected in the peritoneal tissue and peritoneal swab culture. Peritoneal tissue injury score was 2 +/- 1.4 in controls and 2.8 +/- 1.7 in the patients with appendicitis (P>0.05). MLN injury score was 2.5 +/- 1.3 in controls and 3.2 +/- 1.5 in the patients with appendicitis (P>0.05). No patient developed wound and systemic infection. No significant bacterial translocation frequency and tissue injury score was identified in the children with noncomplicated acute appendicitis. This result suggests that antibiotic prophylaxis may be unnecessary in such patients.
authors.affiliation: Department of Pediatric Surgery, Akdeniz University School of Medicine, 07070, Antalya, Turkey. adaslan@yahoo.com
authors.forename: Adnan
authors.initials: A
authors.lastname: Aslan
authors.forename: Cagdas
authors.initials: C
authors.lastname: Karaveli
authors.forename: Dilara
authors.initials: D
authors.lastname: Ogunc
authors.forename: Ozlem
authors.initials: O
authors.lastname: Elpek
authors.forename: Gungor
authors.initials: G
authors.lastname: Karaguzel
authors.forename: Mustafa
authors.initials: M
authors.lastname: Melikoglu
mesh_terms: D000293:Adolescent; D019072:Antibiotic Prophylaxis; D001062:Appendectomy; D001064:Appendicitis / Q000503:physiopathology* / Q000601:surgery; D018988:Bacterial Translocation; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000382:microbiology; D008297:Male; D008643:Mesentery; D010537:Peritoneum / Q000382:microbiology; D011446:Prospective Studies