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Microbiology Spectrum Apr 2024The microbiota of perianal abscesses is scarcely investigated. Identifying causative bacteria is essential to develop antibiotic therapy. However, culture-based methods...
The microbiota of perianal abscesses is scarcely investigated. Identifying causative bacteria is essential to develop antibiotic therapy. However, culture-based methods and molecular diagnostics through 16S PCR technology are often hampered by the polymicrobial nature of perianal abscesses. We sought to characterize the microbiota composition of perianal abscesses via metagenomic next-generation sequencing (mNGS). Fourteen patients suffering from perianal abscesses between March 2023 and August 2023 underwent retrospective assessment. Information from medical records was used, including clinical information, laboratory data, and culture and mNGS results. Forty bacterial taxa were identified from perianal abscesses through mNGS, with (71.4%), (57.1%), and (50.0%) representing the most prevalent species. mNGS identified an increased number of bacterial taxa, with an average of 6.1 compared to a traditional culture-based method which only detected an average of 1.1 in culture-positive perianal abscess patients, predominantly (75.0%), revealing the polymicrobial nature of perianal abscesses. Our study demonstrates that a more diverse bacterial profile is detected by mNGS in perianal abscesses, and that is the most prevalent microorganism, potentially serving as a potential biomarker for perianal abscess.IMPORTANCEAccurately, identifying the bacteria causing perianal abscesses is crucial for effective antibiotic therapy. However, traditional culture-based methods and 16S PCR technology often struggle with the polymicrobial nature of these abscesses. This study employed metagenomic next-generation sequencing (mNGS) to comprehensively analyze the microbiota composition. Results revealed 40 bacterial taxa, with (71.4%), (57.1%), and (50.0%) being the most prevalent species. Compared to the culture-based approach, mNGS detected a significantly higher number of bacterial taxa (average 6.1 vs 1.1), highlighting the complex nature of perianal abscesses. Notably, emerged as a potential biomarker for these abscesses. This research emphasizes the importance of mNGS in understanding perianal abscesses and suggests its potential for improving diagnostic accuracy and guiding targeted antibiotic therapy in the future.
Topics: Adult; Humans; Abscess; Escherichia coli; Retrospective Studies; Microbiota; High-Throughput Nucleotide Sequencing; Anti-Bacterial Agents; Bacteroides fragilis; Metagenomics; Skin Diseases; Biomarkers
PubMed: 38385739
DOI: 10.1128/spectrum.03474-23 -
Journal of Paediatrics and Child Health Mar 2010We aimed to assess our experience in treatment and outcome of perianal abscess and/or fistula-in-ano in children.
AIM
We aimed to assess our experience in treatment and outcome of perianal abscess and/or fistula-in-ano in children.
METHOD
The patients who were treated for perianal abscess and/or fistula-in-ano from January 2000 to December 2005 were included. Age, sex, duration of symptoms, number and site of the perianal abscess and/or fistula-in-ano, treatment modality and recurrences were recorded.
RESULTS
The study consisted of 39 patients (36 boys) with a mean age of 29 +/- 49.1 months. At first examination the diagnosis was perianal abscess in 20 patients, perianal abscess with fistula in five patients and fistula-in-ano in 14 patients. No patients had an underlying illness. The primary local treatment of perianal abscess with or without fistula was incision and drainage (with or without antibiotic therapy) in 21 patients, and local care with antibiotic therapy was given to four patients. Of 20 patients with perianal abscess, 17 developed fistula-in-ano and three healed. One patient in the perianal abscess group who developed fistula-in-ano and two patients in the fistula group were lost to follow-up. Thirty-three patients with fistula-in-ano underwent surgical treatment either through a fistulotomy or through a fistulectomy. Five (15.1%) patients who experienced recurrent fistula-in-ano underwent fistulotomy were completely cured after the second operation.
CONCLUSION
Treatment of a perianal abscess either through incision and drainage with antibiotics or through antibiotics alone resulted in a high rate (85%) of fistula formation. Fistula-in-ano can be treated either by fistulotomy or by fistulectomy, both of which are associated with a reasonable chance of recurrence of fistula-in-ano formation. We obtained good results in our patients through surgical approach (fistulotomy or fistulectomy), for fistula-in-ano formed following treatment of perianal abscess.
Topics: Abscess; Adolescent; Age Distribution; Anus Diseases; Child; Child, Preschool; Female; Humans; Infant; Male; Rectal Fistula; Retrospective Studies; Treatment Outcome; Turkey
PubMed: 20105258
DOI: 10.1111/j.1440-1754.2009.01644.x -
Experimental and Clinical... Aug 2022Cytomegalovirus infection after transplant has been dramatically reduced in the modern era with improved understanding of immunosuppression and perioperative transplant... (Review)
Review
Cytomegalovirus infection after transplant has been dramatically reduced in the modern era with improved understanding of immunosuppression and perioperative transplant care. However, cytomegalovirus syndrome with or without tissue invasive disease can still lead to significant morbidity and mortality. Several organs can be involved: most commonly, the gastrointestinal tract, liver, pancreas, lung, and the transplanted renal allograft. Postoperative cytomegalovirus colitis after renal transplant is well recognized and described, with symptoms including abdominal pain, nausea, and diarrhea. Biochemistry can demonstrate pancytopenia with a leukopenia with or without histopathology confirmation. A high index of suspicion is required for a timely diagnosis. This is the first published case report of a patient with cytomegalovirus tissue invasion presenting with a perianal fistula and abscess formation.The diagnosis and management ofthis case with a literature review is discussed.
Topics: Abscess; Cytomegalovirus; Cytomegalovirus Infections; Fistula; Humans; Kidney Transplantation; Treatment Outcome
PubMed: 36044362
DOI: 10.6002/ect.2022.0190 -
Medicina 2020
Topics: Abscess; Anus Diseases; Humans; Rectal Fistula; Skin Diseases
PubMed: 33048810
DOI: No ID Found -
BMC Gastroenterology Sep 2023To study the influence of clinical characteristics and diagnosis and treatment methods of perianal abscess on postoperative recurrence or formation of anal fistula to...
OBJECTIVE
To study the influence of clinical characteristics and diagnosis and treatment methods of perianal abscess on postoperative recurrence or formation of anal fistula to provide a basis for selecting appropriate surgical and inspection methods for clinical treatment of perianal abscess in the future.
METHODS
The clinical data of 394 patients with perianal abscesses were collected, the influencing factors were investigated, and univariate analysis and multivariate logistic regression analysis were performed to further determine the risk factors affecting the prognosis of perianal abscess.
RESULTS
The results showed that the rate of preoperative blood routine results in the uncured group was higher (51.16%) than in the cured group (35.61%); the rate of high abscess space in the uncured group (23.26%) was higher than in the cured group (9.11%); the proportion of patients in the uncured group who underwent magnetic resonance imaging (MRI) before surgery (27.90%) was lower than in the cured group (45.30%); the proportion of patients in the uncured group who underwent simple drainage (51.16%) was higher than in the cured group (28.49%). The two groups had significant differences in perineal MRI examination, surgical method, preoperative blood routine, and abscess space (p = 0.030, p = 0.002, p = 0.047 and p = 0.010, respectively). Based on the results of univariate analysis and multivariate logistic regression analysis, the extent of the abscess cavity (OR = 2.544, 95%CI = 1.087-5.954, p = 0.031) and the surgical method (OR = 2.180, 95%CI = 1.091-4.357, p = 0.027) were independent influencing factors for postoperative recurrence of perianal abscess or anal fistula.
CONCLUSION
Preoperative assessment of the abscess range and precise intraoperative methods to resolve the infection of the abscess glands in the internal mouth can effectively improve the cure rate.
Topics: Humans; Abscess; Anus Diseases; Drainage; Prognosis; Rectal Fistula
PubMed: 37759161
DOI: 10.1186/s12876-023-02959-1 -
Anales de Pediatria Jun 2019There are limited data on the aetiology and management of perianal abscesses (PAs). The aim of this retrospective study was to define the characteristics of children...
INTRODUCTION
There are limited data on the aetiology and management of perianal abscesses (PAs). The aim of this retrospective study was to define the characteristics of children with PAs; describe our experience with PA from the perspective of paediatric infectious medicine and determine the factors that influence clinical outcomes.
METHODS
We performed a retrospective review of cases of PA in children with no underlying disease managed in a tertiary referral hospital between January 2005 and July 2015. We collected data on demographic characteristics, symptoms, abscess size and location, abscess recurrences, laboratory and microbiological findings, treatment modalities, diagnosis of systemic illness at the end of the diagnostic workup and clinical outcomes.
RESULTS
We included a total of 47 patients in the study, with a predominance of male patients (93.6 vs 6.4%, P<.001). The median age was 7.7 months (IQR 1.8-13.7 months), and 40 children (85.1%) were younger than 2 years of age. Four PAs drained spontaneously and 7 healed without need of drainage (23.4%). Drainage by simple incision was applied to 36 patients (76.5%) and six PAs required fistulotomy (12.7%). Recurrent abscesses were found in 25 patients (53.1%). Three patients with recurrent PA were diagnosed with inflammatory bowel disease at the end of the diagnostic evaluation.
CONCLUSIONS
Based on the findings of our study, measurement of white blood cell counts and serum levels of acute phase reactants may be useful in the initial evaluation of children with PA. In light of the high relapse rates observed in surgically managed patients, it seems reasonable to use a conservative approach in patients aged less than 2 years.
Topics: Abscess; Anus Diseases; Female; Humans; Infant; Male; Retrospective Studies
PubMed: 29880418
DOI: 10.1016/j.anpedi.2018.03.020 -
Annals of Emergency Medicine May 1995To review clinical features of perirectal abscesses and to determine appropriate management.
STUDY OBJECTIVE
To review clinical features of perirectal abscesses and to determine appropriate management.
DESIGN
Retrospective analysis of medical records.
SETTING
Urban teaching hospital.
PARTICIPANTS
Ninety-two patients with the discharge diagnosis of perirectal abscess over a 4-year period.
RESULTS
Perirectal pain was the most common presenting symptom, being present in 98.9% of cases. External perianal and digital rectal examination identified an abscess in 94.6% of patients. A variety of aerobic and anaerobic bacteria from skin, bowel, and, rarely, vagina were identified as causative agents, with mixed infections common. The major complications of perirectal abscesses included formation of extensive abscesses and urine retention. Abscess resolution occurred in all patients after adequate drainage. Antibiotics appeared to be useful only as adjunct therapy.
CONCLUSION
Effective management of perirectal abscess involves early, adequate drainage, with antibiotics in an adjunct role.
Topics: Abscess; Adolescent; Adult; Aged; Anti-Bacterial Agents; Causality; Combined Modality Therapy; Diagnosis, Differential; Drainage; Female; Humans; Male; Medical Records; Middle Aged; Rectal Diseases; Retrospective Studies
PubMed: 7741334
DOI: 10.1016/s0196-0644(95)70170-2 -
Journal of Paediatrics and Child Health May 2010
Topics: Abscess; Anal Canal; Anus Diseases; Drainage; Fissure in Ano; Humans; Infant, Newborn; Rectal Fistula
PubMed: 20602669
DOI: 10.1111/j.1440-1754.2009.01694.x -
Arquivos de Gastroenterologia 2022
Topics: Abscess; Anus Diseases; Drainage; Endosonography; Humans; Ultrasonography, Interventional
PubMed: 35830048
DOI: 10.1590/S0004-2803.202202000-56 -
ANZ Journal of Surgery Oct 2016The detection of gut organisms in perianal abscesses has been postulated to suggest an underlying communication with the anal canal. However, recent studies appear to...
BACKGROUND
The detection of gut organisms in perianal abscesses has been postulated to suggest an underlying communication with the anal canal. However, recent studies appear to contradict this observation. The aim of this study is to determine the value of bacteriological studies in perianal abscesses.
METHODS
A retrospective study of all patients who have had a surgical drainage of their perianal abscesses with concomitant microbiological examination from January 2010 to December 2012 was performed. Patients with known underlying anal fistula, Crohn's disease or previous perianal operations were excluded.
RESULTS
A total of 164 patients, median age of 42.0 years (range 8-87) comprising of 78.7% males formed the study group. Gut organisms were cultured in 143 (87.2%) samples while 12 (7.3%) demonstrated skin organisms and nine did not yield any bacterial growth (5.5%). Twenty-nine (17.7%) patients developed anal fistula and 34 (20.7%) patients had a recurrence of the perianal abscess. The median follow-up period was 1450 (14-2391) days. There was no significant association between the presence of gut organism and development of fistulas (odds ratio = 0.48; 95% confidence interval = 0.17-1.37) or recurrence of perianal abscess (odds ratio = 1.66; 95% confidence interval = 0.46-6.01).
CONCLUSION
Bacteriological culture in perianal abscess is not useful for predicting the development of anal fistula or abscess recurrence. Hence, there is no need to perform this investigation on a routine basis.
Topics: Abscess; Adolescent; Adult; Aged; Aged, 80 and over; Anus Diseases; Bacterial Infections; Child; Cost-Benefit Analysis; Drainage; Female; Follow-Up Studies; Humans; Male; Middle Aged; Rectal Fistula; Recurrence; Retrospective Studies; Singapore; Young Adult
PubMed: 27226422
DOI: 10.1111/ans.13630