Analysis of Predictive Factors of Antibiotic Resistant Pseudomonas aeruginosa in Children with Acute Appendicitis

Objectives: To analyze the antibiotic resistance in children with acute appendicitis caused by Pseudomonas aeruginosa (P. aeruginosa), and to explore the predictors of infection and antibiotic resistance in children with acute appendicitis through blood biochemical indicators Methods: Fifty control children (with no bacteria detected in the culture) and 103 children with P. aeruginosa infection who were admitted to the general surgery department of Jiangxi children’s hospital and treated surgically from January 2015 to June 2019 were analyzed. Results: Cefotaxime, cotrimoxazole and tetracycline had the highest drug resistance rates in children with appendicitis caused by P. aeruginosa, with (93.20%, 96/103), (93.20%, 96/103) and (93.20%, 96/103), respectively. There were significant pattern differences between the P. aeruginosa infected group and penicillin antibiotics resistant group. The combination of glutamyltranspeptidase (GGT), phosphorus (P), free fatty acid (FFA) and fibrinogen (CFbg) could effectively identify whether children with acute appendicitis were infected by P. aeruginosa and whether they were resistant to penicillin antibiotics. For the control group and P. aeruginosa infected group, area under the receiver operating characteristic (AUROC) value of the four indicators was 0.9034 (95% CI, 0.8514 - 0.9555), with a sensitivity and specificity of 84.76% and 87.93%, respectively. For the group with or without penicillin antibiotics resistance, the AUROC value was 0.9341 (95% CI, 0.8681 - 1.0000), with a sensitivity and specificity of 89.04% and 96.88%, respectively. Conclusions: Clinical blood biochemical indicators can reflect bacterial infection and antibiotic resistance in children with acute appendicitis to a certain extent, and the combination of GGT, P, FFA, and CFbg can predict P. aeruginosa infection and penicillin antibiotics resistance in children with acute appendicitis.