Anaerobic and aerobic bacteriological studies in biliary tract disease.

Thirty-eight patients without biliary tract disease, 68 patients with gallbladder stones or acalculous chronic cholecystitis, 30 patients with common duct obstruction due to stones or strictures, and 28 patients with common duct obstruction due to tumors or chronic pancreatitis were investigated. Gallbladder bile or common duct bile was cultured anaerobically and aerobically. Anaerobic culture procedures were based on the use of a glove-box and prereduced, anaerobically sterilized media. Transportation of samples was based on evacuation of atmospheric air with oxygen-free carbon dioxide and transportation-time less than 30 minutes. Patients with biliary tract and patients with common duct obstruction not due to stones or strictures did not yield bacteria on culture. Twenty-two per cent of patients with disease of the gallbladder but normal common ducts and 87% of patients with common duct stones or strictures yielded bacteria on culture of the bile. Among 41 patients with infected bile, 39% yielded anaerobic bacteria, either in pure culture (12%) or in mixed culture with anaerobic bacteria (27%). B. fragilis and other non-sporing anaerobic bacteria were most frequently isolated, whereas Clostridium species were found in three patients only.