Incidence and management of appendicitis at 6 years in Shicheng County of China

: Appendicitis is a prevalent disease globally. However, research on appendicitis in county-level regions of China remains limited. This study aimed to investigate the incidence and management strategies of appendicitis and to report bacterial profiles and antibiotic susceptibility patterns. : A retrospective analysis from 2018 to 2023 was conducted. Annual incidence rates were calculated, and changes in treatment approaches were analyzed. Propensity score matching was applied. Furthermore, bacterial culture results and their antibiotic susceptibility profiles were evaluated. : A total of 1,540 cases were included. The overall incidence rate was 90 per 100,000 person-years. The proportion of laparoscopic surgeries increased significantly from 53.2% in 2018 to 96.2% in 2023, which improved clinical outcomes but also led to higher costs. Patients experiencing abdominal pain for more than three days had a significantly higher risk of postoperative complications. Performing appendectomies on weekends or more than one day after admission resulted in higher expenses. Among 830 bacterial cultures, 537 showed bacterial growth, with Escherichia coli being the predominant pathogen (413 isolates, 76.9%), followed by Pseudomonas aeruginosa (41 isolates, 7.6%) and Klebsiella pneumoniae (20 isolates, 3.7%). Escherichia coli demonstrated high sensitivity to ertapenem (100%), piperacillin/tazobactam (99.8%), imipenem (99.5%), and amikacin (99.3%). : The incidence of appendicitis has shown an increasing trend in recent years. The promotion of laparoscopic appendectomy improves clinical outcomes but also increases costs. The duration of abdominal pain and timing of surgery are influencing factors. Escherichia coli remains the primary pathogenic bacterium, showing stable extended-spectrum beta-lactamase positivity and antibiotic susceptibility.