{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T02:27:41Z","timestamp":1777861661660,"version":"3.51.4"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the bacteriological spectrum and antimicrobial resistance of intraoperative purulent samples from patients with acute appendicitis and provide evidence for empirical therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was performed on 110 patients treated between 2021 and 2023. Intraoperative samples were cultured, and susceptibility testing against 20 antibiotics was conducted according to CLSI guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ninety\u2010eight isolates were obtained. Gram\u2010negative bacteria predominated (91.84%), mainly\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Escherichia coli<\/jats:italic>\n                      <\/jats:styled-content>\n                      (71.43%),\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      <\/jats:styled-content>\n                      (7.14%), and\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      <\/jats:styled-content>\n                      (6.12%).\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>E. coli<\/jats:italic>\n                      <\/jats:styled-content>\n                      showed complete susceptibility to meropenem, imipenem, and amikacin, high susceptibility to piperacillin\u2013tazobactam (97.14%) and cefoxitin (88.57%), but high resistance to amoxicillin (94.29%).\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>K. pneumoniae<\/jats:italic>\n                      <\/jats:styled-content>\n                      was universally susceptible to carbapenems, cefoxitin, and amikacin, but resistant to amoxicillin, piperacillin, ticarcillin, cephalothin, and gentamicin.\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>P. aeruginosa<\/jats:italic>\n                      <\/jats:styled-content>\n                      was fully susceptible to carbapenems, cefoxitin, amikacin, and piperacillin\u2013tazobactam, but resistant to most first\u2010 and second\u2010generation cephalosporins and several aminoglycosides.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Gram\u2010negative enteric bacteria, particularly\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>E. coli<\/jats:italic>\n                      <\/jats:styled-content>\n                      , are the dominant pathogens in appendiceal infections. Carbapenems and amikacin retain excellent efficacy, whereas amoxicillin and several commonly used antibiotics show poor activity. Piperacillin\u2013tazobactam represents a reasonable first\u2010line empirical choice, while carbapenems should be reserved for severe infections or patients at risk for resistant organisms. These findings highlight the importance of local resistance surveillance to guide institution\u2010specific antibiotic protocols.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70466","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T11:40:31Z","timestamp":1767094831000},"page":"989-998","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bacteriological Profile and Antimicrobial Resistance in Intraoperative Purulent Samples From Acute Appendicitis: A 3\u2010Year Retrospective Analysis"],"prefix":"10.1111","volume":"96","author":[{"given":"Quanwei","family":"Wang","sequence":"first","affiliation":[{"name":"Department of General Surgery Pinghu Second People's Hospital  Pinghu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of General Surgery 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