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 diseases. METHODS: This prospective study was conducted between April 2010 and August 2011. Patients with various biliary disorders were included. Bile was aspirated by placing a single-use, 5F, standard sphincterotome catheter into the bile duct before the injection of contrast agent during endoscopic retrograde cholangiopancreaticography (ERCP). Bile specimens were transported 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 to the initial gram stain of the positive cultures. RESULTS: Ninety-one patients (27% male, mean age 53.7 ± 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 Escherichia coli (28.2%), Pseudomonas (17.3%) and Stenotrophomonas maltophilia (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 factor 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.
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 diseases. METHODS: This prospective study was conducted between April 2010 and August 2011. Patients with various biliary disorders were included. Bile was aspirated by placing a single-use, 5F, standard sphincterotome catheter into the bile duct before the injection of contrast agent during endoscopic retrograde cholangiopancreaticography (ERCP). Bile specimens were transported 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 to the initial gram stain of the positive cultures. RESULTS: Ninety-one patients (27% male, mean age 53.7 ± 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 Escherichia coli (28.2%), Pseudomonas (17.3%) and Stenotrophomonas maltophilia (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 factor 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.
Entities:
Keywords:
Bacteriobilia; Bile culture; Cholangitis; Endoscopic retrograde cholangiopancreaticography
Authors: Rungsun Rerknimitr; Evan L Fogel; Cem Kalayci; Edward Esber; Glen A Lehman; Stuart Sherman Journal: Gastrointest Endosc Date: 2002-12 Impact factor: 9.427
Authors: Philipp Lenz; Franziska Eckelskemper; Thomas Erichsen; Tim Lankisch; Alexander Dechêne; Gabriele Lubritz; Frank Lenze; Torsten Beyna; Hansjörg Ullerich; Andre Schmedt; Dirk Domagk Journal: World J Gastroenterol Date: 2014-09-14 Impact factor: 5.742
Authors: Jae Min Lee; Sang Hyub Lee; Kwang Hyun Chung; Jin Myung Park; Ban Seok Lee; Woo Hyun Paik; Joo Kyung Park; Ji Kon Ryu; Yong-Tae Kim Journal: World J Gastroenterol Date: 2015-06-28 Impact factor: 5.742
Authors: Theodor Alexandru Voiosu; Andreea Bengus; Andrei Haidar; Mihai Rimbas; Alina Zlate; Paul Balanescu; Andrei Voiosu; Radu Voiosu; Bogdan Mateescu Journal: Maedica (Buchar) Date: 2014-12
Authors: Colin Markus Krüger; Ulrich Adam; Thomas Adam; Axel Kramer; Claus D Heidecke; Frank Makowiec; Hartwig Riediger Journal: World J Gastroenterol Date: 2019-11-07 Impact factor: 5.742