Microbiology of bile in extrahepatic biliary obstruction: A tropical experience

Manrai, Manish; Jha, Atul; Shergill, S.P.S.; Thareja, Sandeep; Sood, Atul Kumar; Shukla, Rajat; Jain, Rahul; Dhiman, Priyank; Gaurab,

doi:10.1016/j.ijmmb.2020.10.002

Cited by 3 publications

(2 citation statements)

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“…Gram-positive bacteria accounted for about 2/3 of positive results, and Enterococcus species were most commonly identified. Sghir et al [ 20 ] reported that Enterococcus species are detected in normal bowel contents of humans, and several studies have demonstrated that preoperative ERCP is a risk factor for bactibilia [ 8 21 22 ]. Considering that the bacterial distribution of patients who underwent ERCP differed from that of patients who did not undergo preoperative procedures in the present study, bactibilia may have resulted from ascending infection of the bowels ( Table 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, among gram-negative bacteria, the most commonly identified microorganisms varied from institution to institution. Manrai et al [ 22 ] have reported that E. coli was the most common and Bass et al [ 27 ] reported that Pseudomonas was the most common gram-negative bacteria. Du et al [ 28 ] reported that Enterococcus was the most commonly identified bacteria in the patients who underwent ERCP, which is in line with the present study.…”

Section: Discussionmentioning

confidence: 99%

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Incidence of bactibilia and related factors in patients who undergo cholecystectomy

et al. 2023

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Purpose In general, bile is normally sterile. However, there are reports bactibilia may occur in certain instances, though the causal factors are unclear. We analyzed possible preoperative predictors of bactibilia upon cholecystectomy. Methods Bile samples were collected during cholecystectomies from November 2018 to November 2019. A total of 428 open or laparoscopic cholecystectomies were performed. Preoperative, intraoperative, and postoperative variables were compared between the culture-positive and culture-negative groups. Results One hundred fifty-seven patients (36.7%) were culture-positive. Gram-negative bacteria (95 [61.0%]) were more common. Escherichia coli (38 [40.0%]) and Enterobacter (22 [23.2%]) were the most common species. In univariate analysis, age of ≥70 years (P < 0.001), male sex (P < 0.001), high American Society of Anesthesiologists physical status grades (P = 0.001), diabetes mellitus (P = 0.002), jaundice (P = 0.007), high Tokyo Guideline grades (P = 0.008), percutaneous transhepatic gallbladder drainage (PTGBD; P < 0.001), endoscopic retrograde cholangiopancreatography (ERCP; P < 0.001) were identified as a risk factors for bactibilia. In multivariate analysis, age of ≥70 years (hazard ratio [HR], 2.874; 95% confidence interval [CI], 1.769–4.670; P = 0.001), ERCP (HR, 9.001; 95% CI, 4.833–16.75; P < 0.001), and PTGBD (HR, 2.866; 95% CI, 1.440–4.901; P = 0.002) were independent risk factors for bactibilia. Conclusion Among patients who underwent cholecystectomy, those who were elderly, symptomatic, and underwent preoperative drainage were more likely to have bactibilia. In such cases, surgeons should take care to prevent bile leakage during surgery and consider administering appropriate antibiotics.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Incidence of bactibilia and related factors in patients who undergo cholecystectomy

et al. 2023

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Bacteriological Spectrum in Bile and Outcomes in Patients of Acute Bacterial Cholangitis

Singh,

George,

Vaithiyam

et al. 2024

Indian J Surg

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Predictive factors associated with Bile culture positivity And phenotypiCal antIbiogram resistance patterns in patients taken to LaparOscopic cholecystectomy (BACILO): protocol for a prospective observational cohort study and development of a prognostic prediction model

Ramírez-Giraldo,

Rodriguez Barbosa,

Isaza-Restrepo

et al. 2024

BMJ Open

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IntroductionBile fluid is aseptic under normal conditions; however, in the presence of cholecystitis, its susceptibility to bacterial colonisation varies, with reported rates of 20%–70% of cases. This process is referred to as bactibilia and/or bacteriobilia and can be considered a secondary complication of biliary stasis and cholecystitis in general. In the management of acute cholecystitis, the antibiotic regimen should be prescribed based on the presumed pathogens involved, taking into consideration the risk factors for resistance patterns according to demographics and local exposure. The aim of this study is to determine the predictive factors for bile culture positivity and antibiotic resistance in patients who underwent laparoscopic cholecystectomy in the Méderi Hospital Network. We hope to develop a predictive model that allows us to better guide antibiotic therapy.Methods and analysisThis is a prospective observational cohort study with prognostic prediction model. Patients who will undergo laparoscopic cholecystectomy and have bile cultures taken in the Méderi Hospital Network during the study period will be included. The dependent variables will be positive bile culture and antibiotic resistance, and the predictive variables will be age, presence of diabetes, diagnosis of choledocholithiasis, diagnosis of cholecystitis and severity of cholecystitis according to the Tokyo criteria. The minimum sample size has been calculated at 703 patients. Follow-up will continue until a control appointment 15 days after the procedure. The primary outcomes are bile culture positivity and phenotypical antibiogram resistance. For each outcome, a multivariate logistic regression will be performed using frequentist and Bayesian prediction techniques.Ethics and disseminationThis study was approved by the Méderi network research department committee (CIMED) and by Universidad del Rosario’s Research Ethics Committee (CEI-UR; DVO005 2555-CV1837). Written informed consent is required for participation. The results will be disseminated through the submission of an academic article to a high-impact scientific journal, presentations at academic conferences, and sharing with our institution's faculty to inform antimicrobial therapy management based on local epidemiological data.Trial registration numberNCT06314399.

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Microbiology of bile in extrahepatic biliary obstruction: A tropical experience

Cited by 3 publications

References 13 publications

Incidence of bactibilia and related factors in patients who undergo cholecystectomy

Incidence of bactibilia and related factors in patients who undergo cholecystectomy

Bacteriological Spectrum in Bile and Outcomes in Patients of Acute Bacterial Cholangitis

Predictive factors associated with Bile culture positivity And phenotypiCal antIbiogram resistance patterns in patients taken to LaparOscopic cholecystectomy (BACILO): protocol for a prospective observational cohort study and development of a prognostic prediction model

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