Resumen de Microorganisms isolated from the bile of the patients who have undergone cholecystectomy and their antibiotic resistance pattern: multicenter prospective study
Derya Ozturk Engin, Canan Agalar, Yasemin Cag, Fatma Kesmez Can, Ilker Inanç Balkan, Oguz Karabay, Seniha Senbayrak, Busra Meral Çetinkaya, Mehmet Timuçin Aydın, Kadir Tomas, Esra Disci, Ali Surmelioglu, Orhan Alimoglu, Ozgur Ekinci, Emrah Akın, Mehmet Köroglu, Mehmet Velidedeoglu, Handan Ankaralı, Esra Kocoglu, Mirkhaliq Javadov, Berrin Papilla Kundaktepe, Naz Oguzoglu, Erkan Ozmen, Ramazan Donmez, Ertunç Mega, Sebahat Aksaray, Fatih Agalar
Background Gallbladder and biliary tract infections are diseases with high mortality rates if they are not treated properly. Microbiological evaluation of perioperatively collected samples both ensures proper treatment of patients and guides empirical treatment due to the determination of microorganism susceptibility.
Aims This study aimed to isolate the microorganisms in bile cultures from patients who underwent cholecystectomy and to determine sensitivity results of these microorganisms.
Methods This study was a multi-center and prospective design, included 360 patients, and was performed between 2019 and 2020. Culture results of bile taken during cholecystectomy were evaluated.
Results Bacterial growth was found in the bile cultures of 84 out of 360 (23.3%) patients. Patients were divided into two groups according to whether they had risk factors for resistant microorganisms or not. While Escherichia coli (n = 11, 13%), Enterococcus spp. (n = 8, 9.5%), and Enterobacter spp. (n = 4, 4.7%) were detected most frequently in patients without risk. Staphylococcus spp. (n = 17, 20.2%), Enterococcus spp. (n = 16, 19%), and E. coli (n = 8, 9.5%) were the most frequently found microorganism at-risk patients. In multivariate analysis, bile culture positivity was found higher in patients who had history of biliary disease (p = 0.004), operation performed concurrently with a cholecystectomy (p = 0.035), and high rate of polymorphonuclear leukocytes (PNL) in total leukocyte count (p = 0.001).
Conclusions Our study shows that when starting empirical antibiotic treatment for bile ducts, whether patients are at risk for the development of resistant bacterial infection should be evaluated after which antibiotic selection should be made accordingly.
