Microbial profile and antibiotic sensitivity pattern in bile cultures from endoscopic retrograde cholangiography patients

• Published in: World journal of gastroenterology : WJG Vol. 18; no. 27; pp. 3585 - 3589
• Main Author: Kaya, Muhsin
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Co., Limited 21-07-2012
• Subjects: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Bacteria - classification; Bacteria - drug effects; Bacteria - growth & development; Bacteria - isolation & purification; Bile - microbiology; Brief; Chi-Square Distribution; Cholangiopancreatography, Endoscopic Retrograde; Cholangitis - diagnosis; Cholangitis - microbiology; Cholangitis - surgery; Cholestasis - diagnosis; Cholestasis - microbiology; Cholestasis - surgery; Disk Diffusion Antimicrobial Tests; Drug Resistance, Bacterial; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Prospective Studies; Turkey; Young Adult; 微生物实验室; 患者; 抗生素; 敏感性; 胆汁; 胆管; 血培养; 造影剂; Turkey; Bile culture; Endoscopic retrograde cholangiopancreaticography; Bacteriobilia; Cholangitis
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v18.i27.3585

AIM： To identify the frequency of bacterial growth, the most commonly grown bacteria and their antibiotic susceptibility, and risk factors for bacterial colonization in bile collected from patients with different biliary dis- eases. METHODS： This prospective study was conducted be- tween April 2010 and August 2011. Patients with vari- ous biliary disorders were included. Bile was aspirated by placing a single-use, 5F, standard sphincterotome catheter into the bile duct before the injection of con- trast agent during endoscopic retrograde cholangio- pancreaticography （ERCP）. Bile specimens were trans- ported to the microbiology laboratory in blood culture bottles within an anaerobic transport system. Bacteria were cultured and identified according to the standard protocol used in our clinical microbiology laboratory. The susceptibilities of the organisms recovered were identified using antimicrobial disks, chosen according tothe initial gram stain of the positive cultures RESULTS： Ninety-one patients （27% male, mean age 53.7 4- 17.5 years, range： 17-86 years） were included in the study. The main indication for ERCP was benign biliary disease in 79 patients and malignant disease in 12 patients. The bile culture was positive for bacterial growth in 46 out of 91 （50.5%） patients. The most frequently encountered organisms were Gram-negative bacteria including Escherich/a coli （28.2%）, Pseudo- monas （17.3%） and Stenotrophomonas rnaltophilia （15.2%）. There were no significant differences between patients with malignant and benign disease （58% vs 49%, P = 0.474）, patients with acute cholangitis and without acute cholangitis （52.9% vs 50%, P = 0.827）, patients who were empirically administered antibiotics before intervention and not administered （51.4% vs 60.7%, P = 0.384）, with regard to the bacteriobilia. We observed a large covering spectrum or low resistance to meropenem, amikacin and imipenem. CONCLUSION： We did not find a significant risk fac- tor for bacteriobilia in patients with biliary obstruction. A bile sample for microbiological analysis may become a valuable diagnostic tool as it leads to more accurate selection of antibiotics for the treatment of cholangitis.