Document Detail


Microbial profile and antibiotic sensitivity pattern in bile cultures from endoscopic retrograde cholangiography patients.
MedLine Citation:
PMID:  22826624     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To identify the frequency of bacterial growth, the most commonly grown bacteria and their antibiotic susceptibility, and risk factors for bacterial colonization in bile collected from patients with different biliary diseases.
METHODS: This prospective study was conducted between April 2010 and August 2011. Patients with various biliary disorders were included. Bile was aspirated by placing a single-use, 5F, standard sphincterotome catheter into the bile duct before the injection of contrast agent during endoscopic retrograde cholangiopancreaticography (ERCP). Bile specimens were transported to the microbiology laboratory in blood culture bottles within an anaerobic transport system. Bacteria were cultured and identified according to the standard protocol used in our clinical microbiology laboratory. The susceptibilities of the organisms recovered were identified using antimicrobial disks, chosen according to the initial gram stain of the positive cultures.
RESULTS: Ninety-one patients (27% male, mean age 53.7 ± 17.5 years, range: 17-86 years) were included in the study. The main indication for ERCP was benign biliary disease in 79 patients and malignant disease in 12 patients. The bile culture was positive for bacterial growth in 46 out of 91 (50.5%) patients. The most frequently encountered organisms were Gram-negative bacteria including Escherichia coli (28.2%), Pseudomonas (17.3%) and Stenotrophomonas maltophilia (15.2%). There were no significant differences between patients with malignant and benign disease (58% vs 49%, P = 0.474), patients with acute cholangitis and without acute cholangitis (52.9% vs 50%, P = 0.827), patients who were empirically administered antibiotics before intervention and not administered (51.4% vs 60.7%, P = 0.384), with regard to the bacteriobilia. We observed a large covering spectrum or low resistance to meropenem, amikacin and imipenem.
CONCLUSION: We did not find a significant risk factor for bacteriobilia in patients with biliary obstruction. A bile sample for microbiological analysis may become a valuable diagnostic tool as it leads to more accurate selection of antibiotics for the treatment of cholangitis.
Authors:
Muhsin Kaya; Remzi Beştaş; Fatma Bacalan; Ferhat Bacaksız; Esma Gülsun Arslan; Mehmet Ali Kaplan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  18     ISSN:  2219-2840     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-24     Completed Date:  2012-12-03     Revised Date:  2014-05-20    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  3585-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents / therapeutic use*
Bacteria / classification,  drug effects*,  growth & development,  isolation & purification*
Bile / microbiology*
Chi-Square Distribution
Cholangiopancreatography, Endoscopic Retrograde*
Cholangitis / diagnosis,  microbiology*,  surgery
Cholestasis / diagnosis,  microbiology*,  surgery
Disk Diffusion Antimicrobial Tests
Drug Resistance, Bacterial
Female
Humans
Male
Microbial Sensitivity Tests
Middle Aged
Prospective Studies
Turkey
Young Adult
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents
Comments/Corrections

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