Appendical Perforation by Infection with Extended-Spectrum Beta-Lactamase (ESBL)-Producing Escherichia coli Case Report英文文献资料.docVIP

Surgical Science, 2012, 3, 53-55 /10.4236/ss.2012.31009 Published Online January 2012 (http://www.SciRP.org/journal/ss) Appendical Perforation by Infection with Extended-Spectrum Beta-Lactamase (ESBL)-Producing Escherichia coli: Case Report Hisayuki Miyagi , Tadao Okada , Shohei Honda , Masashi Minato , 1 1* 1 1 2 Akinobu Taketomi Department of Pediatric Surgery, Hokkaido University Hospital, Sapporo, Japan 1 2 Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan * Email: okadata@med.hokudai.ac.jp Received September 25, 2011; revised November 30, 2011; accepted December 9, 2011 ABSTRACT We report the very rare case of a huge appendical abscess with extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) as the pathogen. There have been several reports of appendical infections such as appendicitis and appendical abscess caused by ESBL-producing bacteria in adults. The treatment of ESBL-producing E. coli infec- tion is specific, and ESBL-producing bacteria have recently been reported as pathogens associated appendicitis in chil- dren. To the best of our knowledge, this is the second report of perforated appendicitis with abscess due to ESBL-pro- ducing E. coli. We discuss the diagnostic modalities and treatments for appendical abscess with ESBL-producing E. coli. and propose that the patients with perforated appendicitis and abscess formation due to ESBL-producing E. coli should be administered the antibiotic MEPM within 2 weeks to treat the abscess more effectively without producing other mul- tidrug-resistant bacteria. Keywords: Appendicitis; ESBL (Extended-Spectrum Beta-Lactamase)-Producing E. coli; Abscess; Meropenem 1. Introduction complicated by the ESBL-producing E. coli. Beta-lactamases open the beta lactam ring of antibiotics and con