Introduction: Gallstone disease is one of the most common disease affecting the gastrointestinal tract. Biliary tract infection results from bile stasis due to chronic obstruction, mainly (80%) gallstones. Biliary obstruction increases ductal pressure, resulting in bacterial proliferation and dissemination. Proper guidelines for appropriate use of antibiotics in managing uncomplicated and complicated gallstone disease are lacking; on the other hand, the antibiotic usage for its management cover a broad spectrum of organism which may not be required most of the times. This study aims to determine the microbiology of the bile culture and antimicrobial susceptibility in patients with symptomatic gallstone disease in our setup.   Methods: This prospective study included patients admitted in surgery department with a diagnosis of symptomatic gallstone disease and subjected for laparoscopic or open cholecystectomy from 1st of Oct 2015 to 30th Sep 2016. The intraoperative bile of patients subjected for cholecystectomy were cultured aerobically in Blood agar and MacConkey agar. The isolates were identified and tested for their sensitivity pattern. The data were collected, entered and then analyzed using SPSS version 23. The descriptive statistics were calculated.   Results: Of the total 259 patients, bile culture was negative in 183 patients (70.7%) and was positive in only 76 patients (29.3%). Pseudomonas was the most common cultured organism in 52 (68.4%) patients. Other isolated organisms included E. coli, Staphylococcus, Klebsiella, Enterococci, and Acinetobacter. Imipenem and amikacin were the most effective prophylactic antibiotics.   Conclusion: Bile culture was negative in majority of patients with symptomatic gallstone disease. Few patients are positive in culture with predominantly Pseudomonal growth, mostly sensitive to amikacin or imipenem.

Introduction: Surgical site infection is a common complication shown in literature following cholecystectomies. Smaller incision and use of trocars in laparoscopic cholecystectomy lessen the contamination resulting in less chances of surgical site infection. However, in fear of postoperative infection, many opt for the prolonged postoperative use of antibiotic and there is growing consensus against it. Antibiotics not only increases the cost and hospital stay duration but it aids in emergence of multidrug resistance. Because of the controversies, we conducted this clinical trial to see whether a single prophylactic dose of antibiotic at the time of induction of anesthesia for laparoscopic cholecystectomy was equally effective in controlling post-operative infection as multi-dose antibiotics during and post-operative period. Methods: The study was conducted at the department of general surgery, Lumbini Medical College Teaching Hospital, from November  2015 to October 2016. All cases with symptomatic cholelithiasis subjected for laparoscopic cholecystectomy were enrolled. Patients were randomized into two groups; Group SD received single dose of an intravenous dose of amikacin 500 mg, at induction of anesthesia and Group MD received multiple intravenous dose of amikacin, during and postoperatively for two days. Complications, hospital stay, and treatment cost in two groups were compared and analyzed. Results: There were a total of 240 patients in the study, 118 in Group SD and 122 in Group MD. Post-operative infection rate was 4.2% (n= 5, N=118) in Group SD and 3.3% (n=4, N=122) in Group MD; the difference was not significant (p=0.75). Hospital stay was prolonged and cost was higher significantly in Group MD. Conclusion: Single dose of prophylactic antibiotic, administered at induction of anesthesia, is equally effective as multiple doses of post surgical antibiotics to prevent post-operative infection in patients undergoing elective laparoscopic cholecystectomy for uncomplicated cholelithiasis.

Antimicrobial activity of two wild mushrooms groups namely Ganoderma spp. and Agaricus spp. against pathogenic bacteria of human was tested. The activity of the fungal mass was studied by direct cross inoculation techniques and that of chloroform extract of the fungi grown in liquid culture media was tested by agar well diffusion technique. The study revealed that fungal body of Ganodarma was ineffective against all the tested bacterial pathogens, while the extract of the same mushroom was effective against Salmonell typhi, S. paratyphy, S. dysentriae, Pseudomonas aeruginosa, Vibrio cholerae, Klebsella oxytoca, P. vulgaris, P. mirabilis and Staphylococcus aureus, and ineffective against Escherichia coli and Klebsella pneumoniae. in direct cross inoculation, Agaricus spp. totally inhibited Salmonella typhi, S. paratyphi. Escherichia coli, P. aeruginosa, V. cholera, K pneumoniae, P. vulgaris and P. mirabilis, and the rest were inhibited partially. The chloroform extract of Agaricus spp. was effective against all of the tested bacteria. <i> Nepal Journal of Science and Technology</i> Vol. 7, 2006

Introduction: Surgical site infection is a common complication shown in literature following cholecystectomies. Smaller incision and use of trocars in laparoscopic cholecystectomy lessen the contamination resulting in less chances of surgical site infection. However, in fear of postoperative infection, many opt for the prolonged postoperative use of antibiotic and there is growing consensus against it. Antibiotics not only increases the cost and hospital stay duration but it aids in emergence of multidrug resistance. Because of the controversies, we conducted this clinical trial to see whether a single prophylactic dose of antibiotic at the time of induction of anesthesia for laparoscopic cholecystectomy was equally effective in controlling post-operative infection as multi-dose antibiotics during and post-operative period.   Methods: The study was conducted at the department of general surgery, Lumbini Medical College Teaching Hospital, from November  2015 to October 2016. All cases with symptomatic cholelithiasis subjected for laparoscopic cholecystectomy were enrolled. Patients were randomized into two groups; Group SD received single dose of an intravenous dose of amikacin 500 mg, at induction of anesthesia and Group MD received multiple intravenous dose of amikacin, during and postoperatively for two days. Complications, hospital stay, and treatment cost in two groups were compared and analyzed.   Results: There were a total of 240 patients in the study, 118 in Group SD and 122 in Group MD. Post-operative infection rate was 4.2% (n= 5, N=118) in Group SD and 3.3% (n=4, N=122) in Group MD; the difference was not significant (p=0.75). Hospital stay was prolonged and cost was higher significantly in Group MD.   Conclusion: Single dose of prophylactic antibiotic, administered at induction of anesthesia, is equally effective as multiple doses of post surgical antibiotics to prevent post-operative infection in patients undergoing elective laparoscopic cholecystectomy for uncomplicated cholelithiasis.