DOI: https://doi.org/10.22263/2312-4156.2025.3.49
M.A. Litviakou1, K.M. Kubrakou2, V.M. Semenov2
Evaluation of beta-lactamase activity of the peritoneal exudate in acute destructive appendicitis in children
1Vitebsk Regional Pediatric Clinical Hospital, Vitebsk, Republic of Belarus
2Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2025;24(3):49-58.
Abstract.
Objectives. To study the level of beta-lactamase activity (BLA) of peritoneal exudate (PE) in healthy children and children with acute destructive appendicitis (ADA) and to determine its threshold value.
Material and methods. The study covered 127 children treated in the surgical department of Vitebsk Regional Children's Clinical Center. The main group included 91 children operated on for acute destructive appendicitis. The control group consisted of 36 children who were undergoing inpatient treatment for planned surgical and urological pathologies.
Peritoneal exudate was collected for diagnostic purposes during an emergency operation. The obtained material was sent to the laboratory for bacteriological analysis and determination of BLA using the Biolactam test system (OOO SIVital, Republic of Belarus). The studies were performed in accordance with standard approved laboratory research methods.
Results. Among the causative agents of acute destructive appendicitis in children, gram-negative bacteria predominate (p<0.05), and Escherichia coli is the most common. Most of the obtained strains in both subgroups show high rates of resistance to beta-lactam antibacterial drugs (ALDs), such as ampicillin, cefuroxime, cephalothin, cefotaxime, cefaclor and ceftriaxone.
Using the Biolactam test system, the level of BLA in PE in patients with acute destructive appendicitis is 60.4% (44.9-69), which is significantly higher than the level of BLA in PE in patients of the control group - 36% (31.25-43.25). Using ROC analysis, it has been determined that with BLA in PE >49%, it is necessary to take into account the possible inefficiency of beta-lactam ALDs.
Conclusions. The study confirmed the importance of assessing the BLA PE for improving the treatment outcomes of children with acute destructive appendicitis and its complications.
Keywords: beta-lactamase activity, acute destructive appendicitis, peritonitis, pediatric surgery, bacteriology, microorganism, antibiotic, resistance.
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Submitted 18.04.2025
Accepted 13.06.2025
Information about authors:
Mikhail A. Litviakou – Head of the surgical department, Vitebsk Regional Pediatric Clinical Hospital, https://orcid.org/0000-0002-8209-5060, e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра.;
K.M. Kubrakou – Doctor of Medical Sciences, associate professor, professor of the Chair of Neurology & Neurosurgery, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0001-6723-0589
V.M. Semenov – Doctor of Medical Sciences, professor, head of the Chair of Infectious Diseases with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-7029-9226
