ArticleFrontiers in pediatrics2026
Microbiological spectrum and antimicrobial resistance patterns in pediatric acute appendicitis: implications for evidence-based empirical therapy.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Acute appendicitis is one of the most common surgical emergencies in children, and timely empirical antimicrobial therapy is particularly important in complicated cases. However, antibiotic selection is increasingly challenged by regional variability in pathogen distribution and antimicrobial resistance. This study aimed to characterize the microbiological spectrum and antimicrobial susceptibility profiles of purulent specimens from pediatric patients with acute appendicitis and to provide evidence for optimized empirical therapy. Methods: In this prospective observational study, intraoperative purulent specimens were collected from 70 consecutive pediatric patients diagnosed with acute appendicitis between January 2024 and January 2025 at the Second Affiliated Hospital of Fuyang Normal University. All patients received a standardized preoperative antimicrobial regimen (cefuroxime 50 mg/kg plus metronidazole 7.5 mg/kg, administered intravenously within 30-60 min before surgical incision), which was documented for each case. Bacterial identification was performed using the VITEK® 2 Compact system. Antimicrobial susceptibility testing was conducted by broth microdilution in accordance with current Clinical and Laboratory Standards Institute (CLSI) guidelines. Extended-spectrum Results: Pathogens were isolated from 62 of 70 specimens, yielding a culture-positive rate of 88.6%. Gram-negative bacteria predominated (98.3%), whereas only one Gram-positive isolate was identified. Conclusions: Pediatric acute appendicitis in this cohort was dominated by Gram-negative pathogens, particularly ESBL-producing
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