Bactibilia and Antibiotic Resistance in Elective Cholecysctectomy: An Updated Ecologic Survey

Abstract

Although the influence of bactibilia in developing surgical complications is limited, its composition and the high rate of resistance can be influential enough to modify antibiotic treatment in biliary tract infections, especially in high-risk patients.

Bactobilia Among Patients with Uncomplicated Cholelithiasis Undergoing Laparoscopic Cholecystectomy: The Risk Factors and Effects on Postoperative Infectious Complications

“…In the present study, there was no correlation between bactobilia and postoperative infectious complications, which is in agreement with some other studies (6,7,12,17). On the contrary, some studies have reported a higher incidence of postoperative infectious complications in patients in where bactobilia was detected, especially when cholecystectomy is performed in patients with complicated gallstone disease (13).…”

“…In one patient, we isolated acinetobacter the risk factor, and the possibility of this type of contamination related to the hospital, and it is not expected to be isolated from healthy non-hospitalized patients. It was shown recently that prolonged bile duct obstruction leads to an impaired intestinal wall barrier and as a result, bacteria can colonize bile easier, thus, it is not surprising that gramnegative enteric bacteria, especially E. coli, are the most common bacteria causing bactobilia in many studies including ours (13)(14)(15)(16)(17)(18). In our study, imipenem and aminoglycosides, especially amikacin, were the most effective antibiotics.…”

The effect of prolonged antibiotics on postoperative complications for common bile duct stones: A post hoc analysis of an EAST multicenter study

“…7,23 However, CBD stones can cause biliary stasis, which is associated with higher rates of bactibilia (bacterial colonization of bile) compared with symptomatic cholelithiasis. 24,25 Additional factors connected to bactibilia include acute cholecystitis, intraoperative gallbladder rupture, immunosuppression, and older than 70 years. 26 These variables are also known risk factors for postoperative SSIs, 7,24,27 yet bactibilia has not been shown to be a risk factor for the development of SSIs.…”

“…24,25 Additional factors connected to bactibilia include acute cholecystitis, intraoperative gallbladder rupture, immunosuppression, and older than 70 years. 26 These variables are also known risk factors for postoperative SSIs, 7,24,27 yet bactibilia has not been shown to be a risk factor for the development of SSIs. 24,25 Although we found no difference in postoperative sepsis or SSIs, we did observe a longer hospital LOS among patients receiving a prolonged course of perioperative antibiotics.…”

“…26 These variables are also known risk factors for postoperative SSIs, 7,24,27 yet bactibilia has not been shown to be a risk factor for the development of SSIs. 24,25 Although we found no difference in postoperative sepsis or SSIs, we did observe a longer hospital LOS among patients receiving a prolonged course of perioperative antibiotics. In contrast, de Santibañes et al 10 and Regimbeau et al 11 found no 13 also commented that within the context of antimicrobial stewardship, many surgeons suffer from "clinical inertia," a phenomenon in which clinicians are averse to incorporating newer, evidence-based guidelines.…”