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Chayed Z, Bro Sørensen D, Justesen US, Ellebæk MB, Qvist N. BioFire blood culture identification 2 panel as detector of bacteria in peritoneal fluid from patients with acute appendicitis. Surgery 2024:S0039-6060(24)00282-4. [PMID: 38862277 DOI: 10.1016/j.surg.2024.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 04/04/2024] [Accepted: 04/22/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND Polymerase chain reaction is a method to detect bacterial DNA and is widely used because it delivers results within a few hours with the potential to guide postoperative antibiotic treatment. This study aims to determine if polymerase chain reaction can accurately detect bacteria in the peritoneal fluid compared with conventional culture from patients operated for acute appendicitis. METHODS This prospective cohort study included patients above the age of 18 years who underwent laparoscopic surgery for acute appendicitis. Peritoneal samples were collected before the appendectomy procedure for conventional culture and polymerase chain reaction using the BioFire Blood Culture Identification 2 Panel for comparison. During surgery, the surgeon assessed the appendicitis as either complicated or noncomplicated. RESULTS Samples from 102 patients were eligible for analysis. Twelve samples were polymerase chain reaction positive, and 14 samples were culture positive. The concordance of positive results when comparing these 2 methods was 71.4%. The most commonly found bacteria were Escherichia coli and Bacteroides fragilis. Of the 36 patients with complicated appendicitis, no bacteria were detected by either conventional culture or polymerase chain reaction in 21 (58%) of the patients. In patients with uncomplicated appendicitis, bacteria were demonstrated in 1 out of 66 (2%) patients. CONCLUSION This study suggests that polymerase chain reaction can be used to detect bacteria in the peritoneal fluid and has the potential to guide postoperative antibiotic treatment.
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Affiliation(s)
- Zahraa Chayed
- Department of Clinical Microbiology, Odense University Hospital, Denmark.
| | | | | | - Mark Bremholm Ellebæk
- Research Unit for Surgery, Odense University Hospital, Denmark; University of Southern Denmark, Odense, Denmark
| | - Niels Qvist
- Research Unit for Surgery, Odense University Hospital, Denmark; University of Southern Denmark, Odense, Denmark
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2
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Felber J, Gross B, Rahrisch A, Waltersbacher E, Trips E, Schröttner P, Fitze G, Schultz J. Bacterial pathogens in pediatric appendicitis: a comprehensive retrospective study. Front Cell Infect Microbiol 2023; 13:1027769. [PMID: 37228669 PMCID: PMC10205019 DOI: 10.3389/fcimb.2023.1027769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/30/2023] [Indexed: 05/27/2023] Open
Abstract
Background Appendicitis is a frequent condition, with peak incidences in the second decade of life. Its pathogenesis is under debate, but bacterial infections are crucial, and antibiotic treatment remains essential. Rare bacteria are accused of causing complications, and various calculated antibiotics are propagated, yet there is no comprehensive microbiological analysis of pediatric appendicitis. Here we review different pre-analytic pathways, identify rare and common bacterial pathogens and their antibiotic resistances, correlate clinical courses, and evaluate standard calculated antibiotics in a large pediatric cohort. Method We reviewed 579 patient records and microbiological results of intraoperative swabs in standard Amies agar media or fluid samples after appendectomies for appendicitis between May 2011 and April 2019. Bacteria were cultured and identified via VITEK 2 or MALDI-TOF MS. Minimal inhibitory concentrations were reevaluated according to EUCAST 2022. Results were correlated to clinical courses. Results Of 579 analyzed patients, in 372 patients we got 1330 bacterial growths with resistograms. 1259 times, bacteria could be identified to species level. 102 different bacteria could be cultivated. 49% of catarrhal and 52% of phlegmonous appendices resulted in bacterial growth. In gangrenous appendicitis, only 38% remained sterile, while this number reduced to 4% after perforation. Many fluid samples remained sterile even when unsterile swabs had been taken simultaneously. 40 common enteral genera were responsible for 76.5% of bacterial identifications in 96.8% of patients. However, 69 rare bacteria were found in 187 patients without specifically elevated risk for complications. Conclusion Amies agar gel swabs performed superior to fluid samples and should be a standard in appendectomies. Even catarrhal appendices were only sterile in 51%, which is interesting in view of a possible viral cause. According to our resistograms, the best in vitro antibiotic was imipenem with 88.4% susceptible strains, followed by piperacillin-tazobactam, cefuroxime with metronidazole, and ampicillin-sulbactam to which only 21.6% of bacteria were susceptible. Bacterial growths and higher resistances correlate to an elevated risk of complications. Rare bacteria are found in many patients, but there is no specific consequence regarding antibiotic susceptibility, clinical course, or complications. Prospective, comprehensive studies are needed to further elicit pediatric appendicitis microbiology and antibiotic treatment.
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Affiliation(s)
- Julia Felber
- Department of Pediatric Surgery, University Hospital Dresden – Technical University of Dresden, Dresden, Germany
| | - Benedikt Gross
- Department of Pediatric Surgery, University Hospital Dresden – Technical University of Dresden, Dresden, Germany
| | - Arend Rahrisch
- Department of Pediatric Surgery, University Hospital Dresden – Technical University of Dresden, Dresden, Germany
| | - Eric Waltersbacher
- Department of Pediatric Surgery, University Hospital Dresden – Technical University of Dresden, Dresden, Germany
| | - Evelyn Trips
- Coordination Centre for Clinical Trials, Faculty of Medicine Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Percy Schröttner
- Institute for Microbiology and Virology, University Hospital Dresden – Technical University of Dresden, Dresden, Germany
| | - Guido Fitze
- Department of Pediatric Surgery, University Hospital Dresden – Technical University of Dresden, Dresden, Germany
| | - Jurek Schultz
- Department of Pediatric Surgery, University Hospital Dresden – Technical University of Dresden, Dresden, Germany
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3
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Soltani S, Kesheh MM, Siri G, Faramarzi S, Shahbahrami R, Didehdar M, Erfani Y, Farahani A. The role of viruses in human acute appendicitis: a systematic literature review. Int J Colorectal Dis 2023; 38:102. [PMID: 37069433 DOI: 10.1007/s00384-023-04391-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND There have been debates about the human appendix function, and while previous research suggested it might be a vestigial organ with no functional significance, recent studies have pointed out that it might have an important role in the immune system. Acute appendicitis (AA) is a common cause of emergency abdominal surgery in the world. Some epidemiologic investigations have found an association between appendicitis and viral infections. In this study, we have reviewed systematically articles to discover viral infections that cause appendicitis and find any possible correlations between the two. METHODS This systematic review was performed by searching among electronic databases including Web of Science, PubMed, Scopus, and EMBASE on viruses and appendicitis topics. RESULTS Conducted search leads to 983 results in all databases after the duplicate removal and screening by title, abstract, and full-text based on inclusion criteria lead to 19 studies. There were several assays to detect the viruses, which are thought to be AA causative agents. RT-PCR and immunoassays were the mainstay methods to detect the probable cause. CONCLUSION Investigations suggested that some viruses including measles virus (MV), influenza virus, dengue fever virus (DFV), human immunodeficiency virus (HIV), human herpesviruses, rotavirus, and adenovirus are associated with acute appendicitis. Despite the available reports, the specific mechanisms behind the relationship between acute appendicitis and viral infections are yet to be understood. Therefore, further investigations are necessary to find out the pathogenesis and pathophysiology of viral complications in appendicitis.
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Affiliation(s)
- Saber Soltani
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Mobini Kesheh
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Goli Siri
- Department of Internal Medicine, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Samireh Faramarzi
- Agricultural Research, Education and Extension Organization (AREEO), Razi Vaccine and Serum Research Institute, Karaj, Iran
| | - Ramin Shahbahrami
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Didehdar
- Department of Medical Parasitology and Mycology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Yousef Erfani
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
| | - Abbas Farahani
- Molecular and Medicine Research Center, Khomein University of Medical Sciences, Khomein, Iran.
- Department of Medical Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran.
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4
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De Vitis E, Ricci S, Nieddu F, Moriondo M, Cortimiglia M, Casini A, Lodi L, Indolfi G, Azzari C. Real-time polymerase chain reaction on filter paper spotted samples: a gateway to molecular diagnosis of invasive bacterial diseases for rural areas in low-income countries. Trans R Soc Trop Med Hyg 2021; 116:233-241. [PMID: 34328186 DOI: 10.1093/trstmh/trab107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/25/2020] [Accepted: 07/14/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Bacterial culture is the gold standard for the diagnosis of invasive bacterial diseases (IBDs) but molecular methods are more specific and sensitive. Fresh liquid samples (FLSs) show patent limitations for shipping and storage. We aimed to evaluate the sensitivity and specificity of real-time polymerase chain reaction (PCR) performed on dried sample spots (DSSs) obtained from different biological fluids compared with real-time PCR or culture performed on FLSs. METHODS FLSs positive for Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Escherichia coli, Streptococcus pyogenes, Staphylococcus aureus, Bordetella pertussis and/or Pseudomonas aeruginosa were spotted on filter paper. Real-time PCR was performed on both FLSs and DSSs and results were compared. The stability of the DSS results over time was evaluated. RESULTS Real-time PCR performed on 114 DSSs showed a specificity of 99.1% and a sensitivity of 91.2% for IBD diagnosis. A positive correlation was found between FLS cycle threshold (Ct) and DSS Ct (r=0.84; r2=0.71) with the Pearson statistical test and Bland-Altman analysis showing that 95% of the specimens were within agreeable limits. Although we observed a trend towards signal reduction over time in the DSSs, there was no statistical evidence of an increase in Ct values. Real-time PCR on DSSs was 2.2 times more sensitive than culture. CONCLUSIONS Real-time PCR applied to DSSs may be a useful approach in different situations, such as IBD diagnosis, both for rural areas of low-income countries and family practitioners in various settings.
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Affiliation(s)
- Elisa De Vitis
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, Florence, Italy
| | - Silvia Ricci
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, Florence, Italy
| | - Francesco Nieddu
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, Florence, Italy
| | - Maria Moriondo
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, Florence, Italy
| | - Martina Cortimiglia
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, Florence, Italy
| | - Arianna Casini
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, Florence, Italy
| | - Lorenzo Lodi
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, Florence, Italy
| | - Giuseppe Indolfi
- Department of Paediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Chiara Azzari
- Department of Health Sciences, University of Florence and Meyer Children's University Hospital, Florence, Italy
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5
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Li C, Fu G, Shi Y, Zhang AM, Xia X, Fang Y, Mao X, Jiang J, Song Y, Yang G. Rapid, specific, and sensitive detection of the ureR_1 gene in Klebsiella pneumoniae by loop-mediated isothermal amplification method. ACTA ACUST UNITED AC 2019; 52:e8186. [PMID: 30916220 PMCID: PMC6437934 DOI: 10.1590/1414-431x20198186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 01/21/2019] [Indexed: 12/15/2022]
Abstract
Klebsiella pneumoniae is one of the main pathogenic bacteria that causes nosocomial infections, such as pneumonia, urinary tract infection, and sepsis. Therefore, the rapid and accurate detection of K. pneumoniae is important for the timely treatment of infectious patients. This study aimed to establish a loop-mediated isothermal amplification (LAMP) method for the rapid and sensitive detection of K. pneumoniae-specific gene ureR_1 (Gene ID: 11847803). The ureR_1 gene was obtained through local and online BLAST, and the specific primers were designed for its detection. Positive reactions were observed on all 140 K. pneumoniae clinical isolates while all the 82 non-K. pneumoniae clinical isolates were negative. Plasmids with the specific gene and the mouse blood with K. pneumoniae were used for sensitivity analysis. The detection limit of the LAMP was 1 bacterium/reaction. The results showed that the LAMP targeted to ureR_1 is a fast, specific, sensitive, inexpensive, and suitable method for the detection of K. pneumoniae.
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Affiliation(s)
- Chao Li
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China.,Molecular Medicine Center of Yunnan Province, Kunming, Yunnan, China
| | - Gongyu Fu
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China.,Molecular Medicine Center of Yunnan Province, Kunming, Yunnan, China
| | - Yaoqiang Shi
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China.,Molecular Medicine Center of Yunnan Province, Kunming, Yunnan, China
| | - A-Mei Zhang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China.,Molecular Medicine Center of Yunnan Province, Kunming, Yunnan, China
| | - Xueshan Xia
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China.,Molecular Medicine Center of Yunnan Province, Kunming, Yunnan, China
| | - Yue Fang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China.,Molecular Medicine Center of Yunnan Province, Kunming, Yunnan, China
| | - Xiaoqin Mao
- Molecular Medicine Center of Yunnan Province, Kunming, Yunnan, China.,Department of Clinical Laboratory, First People's Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Jie Jiang
- Molecular Medicine Center of Yunnan Province, Kunming, Yunnan, China.,Department of Clinical Laboratory, First People's Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Yuzhu Song
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China.,Molecular Medicine Center of Yunnan Province, Kunming, Yunnan, China
| | - Guangying Yang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, Yunnan, China.,Molecular Medicine Center of Yunnan Province, Kunming, Yunnan, China.,Yunnan SciSpark Biotechnology Co. Ltd., Kunming, Yunnan, China
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