Clinical, Molecular Biological, and Microbiological Integrated Investigation in Case of Paediatric Acute Complicated and Uncomplicated Appendicitis

Activity: Talk or presentation types › Oral presentation

Description

AA is the most common indication of emergency abdominal surgery in childhood and requires prompt evaluation and recognition of the stage. The aim was to evaluate urine and serum biomarkers for the early and accurate diagnosis of AA, and differentiation of AuA and AcA, to determine the prevailing microbiota, and to evaluate antibacterial sensitivity. . Prospective, single-center randomized controlled cohort study including 153 children (7-18 years) admitted to the hospital due to acute abdominal pain with the possibility of appendicitis. IL-6, NGAL, and LRG1 concentrations in urine and serum were measured on days 0, 2, and 5. Microbiological culture swabs from the appendix and peritoneal cavity were collected intraoperatively.. The s-LRG1 levels of AA versus the Ctr with a cut-off value of 51.69 μg/mL generated an area under the curve AUC of 0.95 (95% CI 0.91-0.99, p<0.001). The s-LRG1 cut-off value was 84.06 μg/mL for AcA diagnosis compared with AuA, and, therefore, it showed a significant AUC of 0.69 (95% CI 0.59-0.80, p=0.001). Median Day 0 s-NGAL was 199.55 ng/mL for AcA, 135.20 ng/mL for AuA, and 90.60 ng/mL for the Ctr (p=0.020). The basal average s-IL-6 levels were 79.45 ng/mL for AcA, 23.14 ng/mL for AuA, and 10.93 ng/mL for the Ctr (p<0.001). On Day 2, s-NGAL levels were higher in AcA than AuA (p<0.001). . A combined diagnostic model of IL-6, LRG1, and NGAL at the ED may provide a new approach for differentiating AA and other causes of abdominal pain, also AcA versus AuA. E. coli is the main causative agent of AuA in children demonstrating a wide range of antibacterial susceptibility. P. aeruginosa is identified more frequently in AcA. Antibiotic treatment strategies in cases of AcA should include antibiotics with different mechanisms of action to achieve a synergistic effect and prevent the development of antibiotic resistance.
Period29 Mar 2023 → 31 Mar 2023
Event titleRīga Stradiņš University 3rd International Interdisciplinary Conference PLACES
Event typeConference
Conference number3
OrganiserRiga Stradins University
LocationRīga, LatviaShow on map
Degree of RecognitionInternational

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