Gallbladder Bacteriology, Histology, and Gallstones

Fukunaga, Francis H.

doi:10.1001/archsurg.1973.01350140033011

Cited by 55 publications

(8 citation statements)

References 8 publications

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“…3,4 These studies document a strong association between the presence of bacteria in bile cultures taken at surgery and the occurrence of subsequent infection. [5][6][7] Prophylactic antibiotics prevent infections even though they do not sterilize bile 8,9 Rates of bactibilia are not reduced by prophylactic antibiotics that achieve bile levels that exceed the minimum inhibitory concentrations of recovered bacteria. 10 Yet, decreased rates of postoperative infection are invariably reported in patients who have received prophylaxis even when rates of bactibilia are similar in treated patients and untreated controls.…”

Section: Methodsmentioning

confidence: 99%

Bacteriological analysis of bile in cholecystectomy patients

et al. 2015

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Background: Cholecystectomy is currently a frequently performed operation. The presence of gallstones within either the gallbladder or biliary tree is associated with the bacterial colonization of the bile. Acute cholangitis spans a continuous clinical spectrum and can progress from a local biliary infection to advanced disease with sepsis and multiple organ dysfunction syndrome. Therefore, it is important to know the microbiological flora of the gallbladder before prophylactic antibiotics are given. Aims & objectives: To evaluate the microbiological profile of bile from gall bladder in patients undergoing cholecystectomy. To determine the appropriate antibiotic for preoperative prophylaxis in cholecystectomy patients based on the microbiological profile of bile. Methods: The study was a prospective study carried out in SSG Hospital. A total of 78 patients undergone cholecystectomy who met the inclusion criteria were included in the study. 3cc bile was aspirated from all patients, this collected bile from gallbladder before cholecystectomy was transported to the laboratory in sterile test-tube. The specimen was evaluated to find out whether it is sterile or has any bacteria present. The types of bacteria are determined and whether the amount of isolate is significant or not. And sensitivity to antibacterial agents against antibiotics was determined. Results: 19 patients showed positive bile culture in which Escherichia coli was the most common isolated bacteria (63.16% among positive bile culture and 15.38% among all patients) and bile was sterile in 59 patients (75.64%). Other organisms isolated were Pseudomonas (3.85%), Klebsiella (2.56%), coagulase negative Staphylococcus and Staphylococcus viridans (1.28%). Positive bile culture was a more common finding (50% of patients were bile culture positive) in patients with acute cholecystitis in this study. Post-operative wound infection is more common (15.79%) in group of patients with isolated organism from bile. There is a strong correlation between bile culture and wound culture (75%). Conclusions: It was found that sensitivity to third-and fourth-generation cephalosporins was higher as compared to aminoglycoside in acute as well as chronic cholecystitis. In this study levofloxacin also shows good sensitivity against isolated organism from bile. Piperacilin and tazobactum also shows good sensitivity against isolated organism from bile and they are more effective against pseudomonas. The resistance to second-generation cephalosporins and aminoglycoside has increased. For preoperative prophylaxis third and fourth-generation cephalosporins and levofloxacin show better promise and may be used as the first line of preoperative prophylaxis in operations for acute and chronic cholecystitis undergoing cholecystectomy.

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Section: Methodsmentioning

confidence: 99%

Bacteriological analysis of bile in cholecystectomy patients

et al. 2015

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“…Acute cholecystitis and cholangitis dominate the biliary tract infections, which are usually secondary to predisposing factors leading to bacteraemia or sepsis and are associated with high rates of morbidity and mortality, especially in geriatric patients with co-morbid illness or even with delayed diagnosis and treatment 1 .The prime reason for biliary tract infections are the ascending infection due to the reflux of duodenal contents and also the blood-borne infection or infection spreading through the portal-venous channels. The other predisposing conditions causing biliary tract infections include critical illnesses such as trauma, burns, sepsis, HIV infection, immunosuppression, diabetes, non-biliary surgery and childbirth 2 .…”

Section: Introductionmentioning

confidence: 99%

Biliary tract infections and their Microbiological Spectrum- A study from coastal region of Southern India

Ballal

Shenoy

Rodrigues

et al. 2019

Infect

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Objective: Biliary tract infections include cholangitis and cholecystitis. They are associated with high morbidity and mortality in elderly patients with co-morbid disease. The present study was undertaken to determine the microbial aetiology causing biliary tract infections and also to study their antimicrobial resistance profile.Materials & methods: A retrospective study was conducted from January 2011 to December 2016 at the Enteric Diseases Division, Kasturba Medical College Hospital, Manipal. Patients with biliary tract infections admitted in tertiary referral health care hospital, Manipal were included for the study. Aerobic and anaerobic bacteriological and fungal aetiology of biliary tract infections were recorded along with their antimicrobial resistance profile.Results: Out of 307 bile samples sent for aerobic culture and susceptibly testing 187 (60.91%) were positive for culture, of which Escherichia coli (44.4%) was the predominant aetiology followed by Klebsiella pneumoniae (27.3%). Among the 14 samples sent for anaerobic culture, 5 (35.75%) specimens showed growth, of which Bacteroides fragilis group was found to be the predominant anaerobe. Among the 201 bacterial pathogens tested for their antimicrobial susceptibility, 108 (53.73%) isolates were resistant, out of which 9 were PDR Enterobacteriaceae with 12 ESBL strains. All the Candida species were susceptible to fluconazole with the exception of C. glabrata and C. krusei. All the anaerobic isolates were found to be susceptible to Metronidazole.Conclusions: The high rate of bacterial infection particularly gram-negative bacteria was recorded. It is necessary that antimicrobial therapy be initiated when culture or the clinical conditions reports caution. Routine aerobic and anaerobic culturing of bile samples with biliary tract infections are imperatively necessary. With the emergence of multidrug resistant pathogens and change in the microbiological spectrum of biliary tract infections, there is a need for the empirical antimicrobial therapy in every clinical setting.

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“…The most commonly isolated organisms from acute cholecystitis are Escherichia coli, Enterococcus, Klebsiella, Clostridium, Bacteroides, and Enterobacter (Fukunaga, 1973;Brook, 1989;Brodsky et al, 2000;Segireddy et al, 2010). These bacterial infections combined with bile acids may lead to aggravated damage of the gallbladder tissue.…”

Section: Introductionmentioning

confidence: 99%