Prevalence of Bacteriobilia in Patients Undergoing Elective Colecystectomy

Oliveira, Rafael Soares de; Silva, Paula da; Queiroz, Carlos Alfredo Salci; Terra-Júnior, Juverson Alves; Crema, Eduardo

doi:10.1590/0102-672020180001e1392

Cited by 9 publications

(15 citation statements)

References 13 publications

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“…In our study, we found a relationship between old age and bactibilia. We found that an age of ≥70 years was a risk factor for bactibilia (HR, 2.874; P = 0.001) and it was consistent with another previous study [ 14 ]. Based on several reports that human immunity decreases with aging, which increases susceptibility to infection, old age can be considered a risk factor for bactibilia [ 15 16 ].…”

Section: Discussionsupporting

confidence: 92%

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: Discussionsupporting

confidence: 92%

Incidence of bactibilia and related factors in patients who undergo cholecystectomy

et al. 2023

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“…La bacteriobilia o infección bacteriana del líquido biliar es causante de patologías de la vía biliar, como la colecistitis y la colangitis 8 . Se calcula que 22 % de la población occidental tiene litiasis biliar, y entre 13 % y el 22 % de estos pacientes desarrollará síntomas 9 .…”

Section: Discussionunclassified

“…Según los hallazgos presentados y la literatura revisada, se encuentra que a pesar de la falta de consenso sobre el uso de la terapia antimicrobiana en los pacientes con colecistitis aguda, las guías de manejo Tokio 2018 sugieren el uso profiláctico de antibiótico en pacientes que tengan riesgo moderado de severidad o la posibilidad de presentar complicaciones 21 , por otro lado, se debe tener en cuenta la toma de cultivos de bilis para la aplicación de un adecuado esquema antimicrobiano enfocado a los diferentes aislamientos microbiológicos, así como es necesario enfocar el manejo hacia los perfiles de sensibilidad y resistencia de cada institución 8 .…”

Section: Discussionunclassified

Caracterización de la flora bacteriana en los pacientes con colelitiasis y colecistitis atendidos en un centro hospitalario de alta complejidad

Gómez-Meléndez¹,

Pérez²,

Támara-Prieto³

et al. 2022

Rev Colomb Cir

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Introducción. Las infecciones del árbol biliar surgen principalmente por estasis asociada a colecistitis aguda, coledocolitiasis y colecistitis alitiásica, siendo pilar del tratamiento un drenaje apropiado y un régimen antibiótico eficaz. El objetivo de esta investigación fue caracterizar la flora bacteriana de los cultivos de bilis. Métodos. Se realizó un estudio observacional, descriptivo, de corte transversal y retrospectivo de pacientes llevados a colecistectomía, colangiopancreatografía retrograda endoscópica y colecistostomía en nuestra institución, a quienes se les tomó cultivo de líquido biliar entre 2017 - 2021. Resultados. Se incluyeron 119 pacientes intervenidos, de los cuales 55,4 % fueron mujeres y el promedio de edad fue de 63,1 (± 16). La clasificación Tokio 2 fue la más frecuente (55,4 %). El germen aislado con mayor frecuencia fue E. coli (51,2 %). El antibiótico más usado fue ampicilina más sulbactam (44,6 %) seguido de piperacilina tazobactam (40,3 %). Conclusión. La Escherichia coli es el germen aislado con mayor frecuencia en infecciones del árbol biliar. No hay claridad con respecto al uso de antimicrobianos de manera profiláctica en esta patología, por esto es conveniente generar protocolos para la toma de muestras y cultivos de bilis en esta población, con el fin de establecer la necesidad del uso de antibióticos y conocer los perfiles de resistencia bacteriana.

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“…Culture-based studies report bacteria in 9% to 54% of patients with gallstone disease without infection ( 5 , 6 ), with the prevalence of gram-negative bacteria, Escherichia sp., Klebsiella sp. and Enterobacter sp., which account for 60.4% of the isolated bacteria ( 5 , 7 ).…”

Section: Introductionmentioning

confidence: 99%

The Use of Microbiological and Laboratory Data in the Choice of Empirical Antibiotic Therapy in Patients Undergoing Laparoscopic Cholecystectomy – the Role of Local Antibiograms

Pašić

2022

ACC

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SUMMARY Antibiotic therapy is indicated during acute cholecystitis. However, in the treatment of uncomplicated cholelithiasis, prophylactic use of antibiotics is controversial. Microbiological and laboratory data are the basis for the choice of antibiotic treatment. However, monitoring and updating local antibiograms is important because they ensure effective therapy in the given clinical environment. The study included 110 consecutive patients who underwent laparoscopic cholecystectomy, divided into the group of uncomplicated cholelithiasis (n=60) and the group of acute cholecystitis (n=50). Preoperative data included age, sex, body mass index, leukocytes, C-reactive protein, and ultrasound examination. Bile samples for bacteriological testing were obtained under aseptic conditions during the surgery. Cultures were evaluated for aerobic, anaerobic and fungal organisms using routine tests. After the surgery, gallbladder specimens were sent for histopathological examination. In the group of uncomplicated cholelithiasis, 6/60 positive samples were found, and in the group of acute cholecystitis, there were 25/50 positive microbiological findings. Citrobacter sp. and Enterococcus faecalis predominated in the group of uncomplicated cholelithiasis, and Escherichia coli, Enterococcus faecalis, Proteus mirabilis and Citrobacter sp. in the group of acute cholecystitis. Antibiotics were administered to 49/50 patients with acute cholecystitis and to 32/60 patients with uncomplicated cholelithiasis. Cefazolin was the most frequently used antibiotic and also the most resistant antibiotic. To conclude, the administration of antibiotics in elective patients is not justified. The results of this study indicate that third-generation cephalosporin or ciprofloxacin + metronidazole should be administered in mild and moderate acute cholecystitis, and fourth-generation cephalosporin + metronidazole in severe acute cholecystitis in this local setting. The appropriate use of antibiotic agents is crucial and should be integrated into good clinical practice and standards of care.

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Prevalence of Bacteriobilia in Patients Undergoing Elective Colecystectomy

Cited by 9 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

Caracterización de la flora bacteriana en los pacientes con colelitiasis y colecistitis atendidos en un centro hospitalario de alta complejidad

The Use of Microbiological and Laboratory Data in the Choice of Empirical Antibiotic Therapy in Patients Undergoing Laparoscopic Cholecystectomy – the Role of Local Antibiograms

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