Intraoperative bile duct cultures in patients undergoing pancreatic head resection: Prospective comparison of bile duct swab versus bile duct aspiration

Korean Guidelines for Use of Antibiotics for Intra-abdominal Infections in Adults

“…Surgical site infection after pancreatic head resection is a major risk factor for acute cholecystitis, and bacterial bile is the main cause. Intraoperative bile duct aspiration improves the culture positivity rate and increases the possibility of selecting appropriate antibiotics in patients undergoing pancreatectomy compared to collecting bile duct samples with cotton swabs [ 131 ].…”

Optimizing Nanopore Sequencing for Rapid Detection of Microbial Species and Antimicrobial Resistance in Patients at Risk of Surgical Site Infections

“…With regard to preventing SSIs in pancreaticoduodenectomy patients, this institution developed a standardized broad-spectrum prophylactic antimicrobial regimen for all patients undergoing pancreaticoduodenectomy. The regimen was based on microbial species and AMR phenotypes detected in historical SSI culture data and includes a 5-day course of intravenously administered ceftriaxone and metronidazole ( 10 , 11 ). Antimicrobial therapy may then be further optimized following identification of microbial species and AMR typing from intraoperative bile cultures.…”

“…Standard cultures (SC), however, can take days to weeks to return actionable results ( 12 , 13 ) and are typically received over the course of 2–4 days. Bile cultures are often polymicrobial, a mixture of anaerobic and aerobic species, carry multiple antimicrobial resistance (AMR) phenotypes, and contain fungal species ( 11 , 14 – 16 ). This contributes to delays in timely results, and the temporal separation between the initial broad-spectrum treatment and the acquisition of all the diagnostic information often results in uncertainty and the administration of multiple empirical antimicrobials ( 17 ).…”