A Study of Bacterial Cultures of Peritoneal Fluid in Acute Nonperforated Appendicitis: Predictive Factors and Effects on Postoperative Clinical Course

Abstract

Purpose: In some children who are operated for acute nonperforated appendicitis, peritoneal fluids collected during operation subsequently become positive for bacteria in cultures. The postoperative recovery empirically often takes longer in patients with bacteria-positive cultures than in those with bacteria-negative ones. We examined the patients whose peritoneal fluids became bacteria-positive in cultures and the effects of being bacteria-positive on postoperative recovery.

Methods: We retrospectively examined 67 patients, who were operated for acute nonperforated appendicitis and from whom we collected peritoneal fluids and contents of the appendix for bacterial culture between April 2015 and December 2018, in terms of the following aspects: patient characteristics, preoperative clinical symptoms, laboratory data, operative findings, and postoperative course.

Results: Peritoneal fluids from 15 patients became bacteria-positive in cultures. No relationship was seen between being bacteria-positive and patient characteristics, preoperative clinical symptoms, laboratory data, operative findings, or complications. On the other hand, there were significant differences in maximum body temperature, postoperative febrile period, postoperative fasting duration, and length of hospital stay.

Conclusions: It seemed difficult to predict whose peritoneal fluids would become bacteria-positive in cultures. On the other hand, the postoperative recovery significantly took longer for patients with bacteria-positive cultures than for those with bacteria-negative cultures. Contamination of peritoneal fluids worsens the postoperative recovery; thus, it would be useful to carry out a bacteriological examination of peritoneal fluids as part of postoperative observation, even in patients with nonperforated appendicitis.