대한대장항문학회

Purpose: The purpose of this study was aimed to disclose main affected organisms in<br>patients with perforated appendicitis and to analyze correlations between culture-sensitivity<br>test and infectious complication.<br>Methods: In 26 of 421 patients who had undergone appendectomy due to acute appendicitis<br>from April 1996 to March 1999, we performed culture-sensitivity test. The clinical records<br>of these patients were collected and reviewed about clinicopathological features and results<br>of culture-sensitivity test, retrospectively. Culture material was collected in BBL transport<br>media with cotton swab and cultured by MacConkey agar plate. The method of MIC by<br>VITEK was used for sensitivity test.<br>Results: Cultured organisms were E. coli (18 cases), Pseudomonas (4), Enterobacter (2),<br>Enterococcus (1), and Proteus (1). In sensitivity test, sensitive antibiotics against all cultured<br>organism were amikacin, ceftriaxone, imipenem and cefotetan. But ampicillin,<br>sulfametoxazole/trimethoprim and piperacillin were mostly resistant. Infectious complications<br>occurred in 11 of 26 patients (42.3%) and consisted of 9 wound infection and 2 intraabdominal<br>abscess. Especially, 13 of 18 cases in which E. coli were isolated, were resistant to ampicillin.<br>And they had infectious complications statistically more than those who were not resistant<br>to ampicillin (p=0.036).<br>Conclusions: E. coli was a main organism in perforated appendicitis. In case of<br>ampicillin-resistant E. coli, the patients were susceptible to infectious complication such as<br>wound infection and intraabdominal abscess.<br>