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Han S, Su W, Fan K, Xu Z, Xu H, Wang M, Li L, Shen W. The bacterial composition signatures of perianal abscess and origin of infecting microbes. PeerJ 2025; 13:e18855. [PMID: 39866571 PMCID: PMC11766672 DOI: 10.7717/peerj.18855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Accepted: 12/20/2024] [Indexed: 01/28/2025] Open
Abstract
Background Perianal abscess is a common anal condition primarily caused by bacterial infections, yet the precise origins of these infecting bacteria remain unclear. Understanding the distinct microbial signatures associated with periaabscesses is crucial for provide fresh ideas for disease prevention. Materials and Methods Samples of anal skin, feces, and abscesses were collected from a cohort of 75 patients diagnosed with perianal abscesses. The microbial composition at each site was analyzed using 16S rRNA gene sequencing to characterize the bacterial communities present. Results Analysis using MaAslin2 revealed distinct bacterial compositional signatures among the anal skin, feces, and abscess samples. Alpha diversity analysis indicated significant differences in bacterial diversity between abscesses, anal skin, and feces, with abscesses showing lower diversity compared to higher richness in feces. Biomarker analysis highlighted key taxa such as Bacteroides and Escherichia-Shisgella in fecal samples, and Staphylococcus and Corynebacterium in anal skin samples. The analysis of abscess samples suggested that the bacterial composition may originate from the skin, feces, and potentially other sources.
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Affiliation(s)
- Song Han
- Department of Anorectal Surgery, Cheeloo College of Medicine, Qilu Hospital (Qingdao), Qingdao, China
| | - Wenya Su
- State Key Laboratory of Microbial Technology, Microbial Technology Institute, Shandong University (Qingdao), Qingdao, Shandong, China
| | - Kefeng Fan
- Department of Respiratory Diseases, Qingdao Chengyang District People’s Hospital, Qingdao, China
| | - Zhen Xu
- Department of Anorectal Surgery, Cheeloo College of Medicine, Qilu Hospital (Qingdao), Qingdao, China
| | - Hai Xu
- State Key Laboratory of Microbial Technology, Microbial Technology Institute, Shandong University (Qingdao), Qingdao, Shandong, China
| | - Mingyu Wang
- State Key Laboratory of Microbial Technology, Microbial Technology Institute, Shandong University (Qingdao), Qingdao, Shandong, China
| | - Ling Li
- State Key Laboratory of Microbial Technology, Microbial Technology Institute, Shandong University (Qingdao), Qingdao, Shandong, China
| | - Wenlong Shen
- Department of Anorectal Surgery, Cheeloo College of Medicine, Qilu Hospital (Qingdao), Qingdao, China
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Li YZ, Zhou FR, Chen XJ, Liu YG. Evaluating the therapeutic impact of Compound Polymyxin B Ointment on postoperative wound healing in patients with perianal abscesses. Front Med (Lausanne) 2024; 11:1496086. [PMID: 39741508 PMCID: PMC11685118 DOI: 10.3389/fmed.2024.1496086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Accepted: 12/04/2024] [Indexed: 01/03/2025] Open
Abstract
Introduction Perianal abscesses pose a considerable obstacle in the realm of postoperative wound treatment owing to their elevated susceptibility to infection and associated consequences. Polymyxin B Ointment, a compound renowned for its antibacterial qualities, has the potential to provide therapeutic advantages by promoting wound healing and mitigating postoperative problems. Methods Our institution conducted a thorough retrospective analysis spanning from December 2020 to December 2023 to assess the effectiveness of Compound Polymyxin B Ointment in the management of surgical wounds in patients diagnosed with perianal abscesses. The research encompassed a cohort of 100 individuals, who were classified into two groups: a control group that received conventional postoperative care, and an observation group that received supplementary treatment with Compound Polymyxin B Ointment. The evaluation of clinical outcomes involved measuring wound healing effectiveness, pain intensity using the Visual Analogue Scale (VAS), tissue swelling, exudation, necrotic tissue shedding time, duration of hospital stays, and rate of reduction in wound area. Results The group that received Compound Polymyxin B Ointment had significant enhancements in wound healing, as seen by a noteworthy 46% of participants completing complete healing, in contrast to the control group's 32%. The VAS was used to quantify pain levels, and the observation group reported a substantial reduction of almost 50% in ratings. Furthermore, this cohort exhibited a 45% decrease in edema and a 50% decline in exudation rates, in addition to a 50% acceleration in the shedding of necrotic tissue. The duration of the hospital stay was reduced by 40%, and the reduction in wound area was 18% higher, suggesting a more effective healing process. In addition, it is worth noting that the observation group had a lower incidence of problems, so underscoring the effectiveness of the ointment in facilitating wound healing and mitigating postoperative difficulties. Discussion The utilization of Compound Polymyxin B Ointment as an adjuvant measure in the surgical treatment of perianal abscesses has been found to have a substantial positive impact on wound healing, pain relief, and complication reduction. This finding provides evidence for the possibility of the ointment as a helpful inclusion in post-surgical wound care procedures among this specific group of patients.
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Affiliation(s)
| | | | | | - Yong-Gan Liu
- Department of Anorectal, The People’s Hospital of Zhongshan, Zhongshan, Guangdong, China
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Paran M, Dagan J, Hameiri G, Dudkiewicz M, Kessel B. Does microbiology of perianal abscesses affect the length of hospital stay? Am J Med Sci 2024; 368:320-324. [PMID: 38801949 DOI: 10.1016/j.amjms.2024.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 05/21/2024] [Accepted: 05/24/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Perianal abscess is a common disease among adults, necessitating surgical drainage. We aimed to assess the role of microbiology and other factors in prolonged hospitalization of patients with perianal abscesses. METHODS This retrospective study included all patients aged 18 or older who underwent surgical incision and drainage for perianal abscess in a single medical center between 2016 and 2020. Data regarding demographics, bacteriological cultures, and length of hospital stay were collected via electronic patient charts. A prolonged hospital stay was defined as a LOS longer than 3 days. RESULTS A total of 791 patients were included, of which 77.5% were male, with a mean age of 43.2. Overall, 46.1% of patients had positive cultures, of which 69.9% were polymicrobial. The most common pathogen found in obtained cultures was Escherichia coli (69.9%), followed by streptococcus species (36.7%) and Bacteroides (26.0%). Females had a significantly longer hospital stay (p = 0.03). Prolonged hospital stay was associated with older age (p < 0.0001), female gender (p = 0.04), and positive cultures for Enterococcus (p = 0.02). CONCLUSIONS This study identified clinical and microbiological risk factors for prolonged hospitalization in patients with perianal abscesses. Further studies are needed to evaluate the association between specific pathogens and rates of complications.
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Affiliation(s)
- Maya Paran
- Department of Pediatric and Adolescent Surgery, Schneider Children's Medical Center, affiliated with The Faculty of Medicine, University of Tel Aviv, Tel Aviv, Israel.
| | - Jasmine Dagan
- Surgical Division, Hillel Yaffe Medical Center, Hadera, Israel, affiliated with Rappoport Medical School, Technion, Haifa, Israel
| | - Gil Hameiri
- Surgical Division, Hillel Yaffe Medical Center, Hadera, Israel, affiliated with Rappoport Medical School, Technion, Haifa, Israel
| | - Mickey Dudkiewicz
- Hillel Yaffe Medical Center, Hadera, Israel, affiliated with Rappoport Medical School, Technion, Haifa, Israel
| | - Boris Kessel
- Surgical Division, Hillel Yaffe Medical Center, Hadera, Israel, affiliated with Rappoport Medical School, Technion, Haifa, Israel
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Guner Ozenen G, Akaslan Kara A, Ozer A, Kacar P, Ergun D, Aydin A, Genisol Ataman I, Polatdemir K, Payza AD, Sorguc Y, Oral A, Bayram N, Devrim I. Perianal abscess in children: an evaluation of microbiological etiology and the effectiveness of antibiotics. Pediatr Surg Int 2023; 39:272. [PMID: 37695379 DOI: 10.1007/s00383-023-05556-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE We aimed to evaluate the demographic characteristics of children with perianal abscess, distribution of microbiological etiology, antibiotic susceptibility, and identify the effectiveness and coverage of antibiotics due to culture results. METHODS A retrospective study was designed to evaluate pediatric patients with perianal abscesses between January 2013 and December 2022. RESULTS A total of 197 episodes in 135 patients were evaluated. The median age of the patients was 10 months (22 days-17 years). The isolated microorganisms were Gram-positive bacteria in 56 (28.4%) patients and Gram-negative bacteria in 141 (71.6%) patients. The most common isolated species was Escherichia coli (n = 70, 35.5%), followed by Klebsiella spp. (n = 48, 24.4%), Staphylococcus aureus (n = 37, 18.9%), and Enterobacter spp. (n = 9, 4.5%). Forthy-two percent (n = 58) of isolates were positive for extended-spectrum beta-lactamase, 8% (n = 11) were carbapenem-resistant in Gram-negative bacteria, and 37.5% (n = 21) were methicillin-resistant, 7.1% (n = 4) were vancomycin-resistant in Gram-positive bacteria. According to bacterial culture results, ertapenem plus glycopeptide had the highest antimicrobial coverage rate (92.3%), followed by ertapenem plus clindamycin (89.8%), ertapenem (81.7%), third-generation cephalosporin plus glycopeptide (82.2%), third-generation cephalosporin plus clindamycin (69.5%). CONCLUSION Ertapenem can be a good choice in the empirical treatment of perianal abscesses in children due to its high coverage rate.
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Affiliation(s)
- Gizem Guner Ozenen
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Children's Hospital, Konak, Izmir, 35210, Turkey.
| | - Aybuke Akaslan Kara
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Children's Hospital, Konak, Izmir, 35210, Turkey
| | - Arife Ozer
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Children's Hospital, Konak, Izmir, 35210, Turkey
| | - Pelin Kacar
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Children's Hospital, Konak, Izmir, 35210, Turkey
| | - Deniz Ergun
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Children's Hospital, Konak, Izmir, 35210, Turkey
| | - Aysenur Aydin
- Department of Pediatrics, University of Health Sciences Dr. Behçet Uz Children's Hospital, Izmir, Turkey
| | - Incinur Genisol Ataman
- Department of Pediatric Surgery, University of Health Sciences Dr. Behçet Uz Children's Hospital, Izmir, Turkey
| | - Kamer Polatdemir
- Department of Pediatric Surgery, University of Health Sciences Dr. Behçet Uz Children's Hospital, Izmir, Turkey
| | - Ayse Demet Payza
- Department of Pediatric Surgery, University of Health Sciences Dr. Behçet Uz Children's Hospital, Izmir, Turkey
| | - Yelda Sorguc
- Department of Medical Microbiology, University of Health Sciences Dr. Behçet Uz Children's Hospital, Izmir, Turkey
| | - Akgun Oral
- Department of Pediatric Surgery, University of Health Sciences Dr. Behçet Uz Children's Hospital, Izmir, Turkey
| | - Nuri Bayram
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Children's Hospital, Konak, Izmir, 35210, Turkey
| | - Ilker Devrim
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Children's Hospital, Konak, Izmir, 35210, Turkey
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Jaiswal P, Sharma S, Pratap A, Ansari M, Shukla VK, Basu S, Banerjee T. Significant presence of biofilm-producing gut-derived bacteria in anal fistula of chronic duration. Int Wound J 2021; 18:519-524. [PMID: 33544431 PMCID: PMC8273591 DOI: 10.1111/iwj.13551] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 01/11/2021] [Indexed: 12/19/2022] Open
Abstract
Fistula-in-ano though not a life-threatening condition, yet its symptoms often significantly impact patients' social, intimate, and work lives. There is an established role of bacterial microflora in acute infections. However, we proposed that biofilm-forming organisms might be present in the microflora of anal fistula of prolonged duration. This aspect has rarely been studied earlier. Therefore, the study describes the microbiology of anal fistula and the biofilm-forming capacity of the isolated organisms. A total of 30 patients were included in the study as per the criteria. Anal fistula tissue sample, tissue fluid, and blood samples were collected from each individual. The collected specimens were detected for the presence of aerobic and anaerobic microflora through standard microbiological method and polymerase chain reaction. Furthermore, the role of biofilm formation by microtitre plate assay and serum matrix metalloproteinases-9 was also studied. The result showed significant predominance of gut-derived microflora with high-to-moderate biofilm-producing ability in anal fistulas of prolonged duration. The study emphasises the presence of biofilm-forming bacteria in chronic, non-healing fistula.
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Affiliation(s)
- Prakhar Jaiswal
- Department of General Surgery, Institute of Medical SciencesBanaras Hindu UniversityVaranasiUttar PradeshIndia
| | - Swati Sharma
- Department of Microbiology, Institute of Medical SciencesBanaras Hindu UniversityVaranasiUttar PradeshIndia
| | - Arvind Pratap
- Department of General Surgery, Institute of Medical SciencesBanaras Hindu UniversityVaranasiUttar PradeshIndia
| | - Mumtaz Ansari
- Department of General Surgery, Institute of Medical SciencesBanaras Hindu UniversityVaranasiUttar PradeshIndia
| | - Vijay K Shukla
- Department of General Surgery, Institute of Medical SciencesBanaras Hindu UniversityVaranasiUttar PradeshIndia
| | - Somprakas Basu
- Department of General SurgeryAll India Institute of Medical SciencesRishikeshUttarakhandIndia
| | - Tuhina Banerjee
- Department of Microbiology, Institute of Medical SciencesBanaras Hindu UniversityVaranasiUttar PradeshIndia
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Tan Tanny SP, Wijekoon N, Nataraja RM, Lynch A, Pacilli M. Surgical management of perianal abscess in neonates and infants. ANZ J Surg 2020; 90:1034-1036. [DOI: 10.1111/ans.15801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 02/14/2020] [Accepted: 02/19/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Sharman P. Tan Tanny
- Department of Paediatric SurgeryMonash Children's Hospital Melbourne Victoria Australia
| | - Naveen Wijekoon
- Department of Paediatric SurgeryMonash Children's Hospital Melbourne Victoria Australia
| | - Ramesh M. Nataraja
- Department of Paediatric SurgeryMonash Children's Hospital Melbourne Victoria Australia
- Department of Paediatrics, School of Clinical Sciences at Monash Health, Medicine, Nursing and Health SciencesMonash University Melbourne Victoria Australia
| | - Amiria Lynch
- Department of Paediatric SurgeryMonash Children's Hospital Melbourne Victoria Australia
| | - Maurizio Pacilli
- Department of Paediatric SurgeryMonash Children's Hospital Melbourne Victoria Australia
- Department of Paediatrics, School of Clinical Sciences at Monash Health, Medicine, Nursing and Health SciencesMonash University Melbourne Victoria Australia
- Department of Surgery, School of Clinical Sciences at Monash Health, Medicine, Nursing and Health SciencesMonash University Melbourne Victoria Australia
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Hsieh MH, Lu YA, Kuo G, Chen CY, Sun WC, Lin Y, Tian YC, Hsu HH. Epidemiology and outcomes of anal abscess in patients on chronic dialysis: a 14-year retrospective study. Clinics (Sao Paulo) 2019; 74:e638. [PMID: 30916172 PMCID: PMC6438129 DOI: 10.6061/clinics/2019/e638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 10/02/2018] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES We conducted this retrospective study to elucidate the clinical presentation and outcomes of anal abscess in chronic dialysis patients. METHODS We performed a chart review of patients who were hospitalized for anal abscess from Jan. 2002 to Dec. 2015. A total of 3,074 episodes of anal abscess were identified. Of these, 43 chronic dialysis patients with first-time anal abscess were enrolled. Patients were divided into a surgical group and a nonsurgical group according to the treatment received during hospitalization. The baseline characteristics, clinical findings, treatments and outcomes were obtained and analyzed. The endpoints of this study were in-hospital mortality, one-year mortality and one-year recurrence. RESULTS Of the 43 patients, 27 (62.7%) received surgical treatment, and 16 (37.2%) received antibiotic treatment alone. There was no significant difference in age, sex, body mass index, smoking habits, comorbidities, or dialysis characteristics between the two groups. Perianal abscess was the most common type of anal abscess, and 39.5% of patients experienced fistula formation. Most patients had mixed aerobic and anaerobic flora. Our data demonstrate that there was no significant difference in hospital stay, one-year survival or recurrence rate between the surgical group and nonsurgical group. However, there was a trend toward better in-hospital survival in patients who received surgical treatment (p=0.082). CONCLUSION In chronic dialysis patients with anal abscess, there was no statistically significant difference in clinical presentation and outcomes between the surgical and nonsurgical groups, although the surgical group had a trend of better in-hospital survival.
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Affiliation(s)
- Meng-Hsuan Hsieh
- Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Yueh-An Lu
- Department of Nephrology, Kidney Research Center, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - George Kuo
- Department of Nephrology, Kidney Research Center, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Chao-Yu Chen
- Department of Nephrology, Kidney Research Center, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Chiao Sun
- Department of Nephrology, Kidney Research Center, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - YuJr Lin
- Research Services Center For Health Information, Chang Gung University, Taoyuan, Taiwan
| | - Ya-Chung Tian
- Department of Nephrology, Kidney Research Center, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Hsiang-Hao Hsu
- Department of Nephrology, Kidney Research Center, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
- Corresponding author. E-mail:
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Abstract
This article covers the diagnosis and treatment of skin and soft tissue infections commonly encountered in the emergency department: impetigo, cutaneous abscesses, purulent cellulitis, nonpurulent cellulitis, and necrotizing skin and soft tissue infections. Most purulent infections in the United States are caused by methicillin-resistant Staphylococcus aureus. For abscesses, we emphasize the importance of incision and drainage. Nonpurulent infections are usually caused by streptococcal species and initial empiric antibiotics need not cover methicillin-resistant Staphylococcus aureus. For uncommon but potentially lethal necrotizing skin and soft tissue infections, the challenge is rapid diagnosis in the emergency department and prompt surgical exploration and debridement.
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Candida albicans as the Sole Organism Cultured from a Perirectal Abscess. Case Rep Infect Dis 2012; 2012:913785. [PMID: 23056968 PMCID: PMC3465875 DOI: 10.1155/2012/913785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Accepted: 08/31/2012] [Indexed: 11/18/2022] Open
Abstract
Perirectal abscess is a common colorectal condition that may be present with or without a fistula. In most cases where a fistula coexists the organisms cultured are gut-derived organisms whereas skin-derived organisms are more common in patients without fistula formation. Candida albicans, despite being an microorganism often found in the gastrointestinal tract, has not previously been reported as an isolate from a perirectal abscess culture. Here we report the case of a patient taking cefazolin in whom a perirectal abscess was diagnosed via computed tomography and aspiration of which demonstrated growth of only C. albicans. Prior literature has demonstrated that the microorganisms cultured from patients with perirectal abscesses do not differ between patients in whom antimicrobials had been used previously and those who were antimicrobial-naïve, suggesting that there is a possibility that C. albicans is the sole organism responsible for the perirectal abscess in our patient. The patient underwent surgical drainage and was discharged with fluconazole and piperacillin/tazobactam, which led to the satisfactory recovery of the patient.
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