Analysis of bile bacterial spectrum and drug resistance in different biliary diseases_West China Medical Journal

Authors：

HAO Jianing ¹ , WANG Yuhong ¹ , KONG Zhe ² , LIU Zhe ² , WANG Jing ² ,  ZHAO Xiaodong ¹

1. Department of Emergency, the Fourth Medical, Center of Chinese PLA General Hospital, Beijing 100048, P. R. China;
2. Department of Hepatobiliary Surgery, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, P. R. China;

Corresponding author：

ZHAO Xiaodong, Email: zxd3715@126.com

Keywords：

Biliary tract infection; antibacterial drugs; extra-and intrahepatic cholangiolithiasis

DOI：

10.7507/1002-0179.202310026

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To clarify the bacterial spectrum and drug resistance of different biliary diseases through bile culture results. Methods Patients who underwent surgical treatment and retained bile for cultivation at the Chinese PLA General Hospital between January 2015 and December 2016 were retrospectively collected. Clinical data such as bile bacterial culture and antibiotic sensitivity results, surgical reasons, and perioperative complications were recorded. Results A total of 272 patients were included, including 142 males and 130 females, aged (53.4 ± 14.1) years old. Intrahepatic and extrahepatic bile duct stones were the most common surgical cause, accounting for 32.4%. The positive rate of bile culture in benign diseases was 78.7%, which was higher than that in malignant diseases (48.5%). The infection related complications (30.0% vs. 6.7%), bile leakage rate (20.8% vs. 6.7%), and poor wound healing rate (24.0% vs. 0.0%) in the bile culture positive group were higher than those in the bile bacteria culture negative group (P<0.05). Among 183 patients with positive bile bacterial culture, a total of 294 strains of pathogenic bacteria were detected. There were 96 patients with single bacterial infection, 66 patients with two bacterial infections simultaneously, 18 patients with three bacterial infections, and 3 patients with four or more bacterial infections. Escherichia coli was the most common bacterium, accounting for 17.0%. There were differences in the positive rate of bile culture among patients with different etiologies (P<0.05). There were significant differences in the sensitivity rate of Enterococcus faecalis and Enterococcus faecalis for many antibacterial drugs. Conclusions There are differences in the positive rate of bacterial culture in the biliary tract of patients with different etiologies, and there is a possibility of mixed infection. It is necessary to select appropriate antibiotics for empirical treatment based on different etiologies. The use of antibiotics should be changed in a timely manner based on the results of bile culture.

Citation： HAO Jianing, WANG Yuhong, KONG Zhe, LIU Zhe, WANG Jing, ZHAO Xiaodong. Analysis of bile bacterial spectrum and drug resistance in different biliary diseases. West China Medical Journal, 2023, 38(11): 1687-1692. doi: 10.7507/1002-0179.202310026 Copy

1.	An Z, Braseth AL, Sahar N. Acute cholangitis: causes, diagnosis, and management. Gastroenterol Clin North Am, 2021, 50(2): 403-414.
2.	Parıldar Z, Çınar C, Barutçuoğlu B, et al. Effects of percutaneous transhepatic biliary drainage on renal function in patients with obstructive jaundice. Diagn Interv Radiol, 2011, 17(1): 74-79.
3.	Kimmings AN, van Deventer SJ, Obertop H, et al. Endotoxin, cytokines, and endotoxin binding proteins in obstructive jaundice and after preoperative biliary drainage. Gut, 2000, 46(5): 725-731.
4.	Pavlidis ET, Pavlidis TE. Pathophysiological consequences of obstructive jaundice and perioperative management. Hepatobiliary Pancreat Dis Int, 2018, 17(1): 17-21.
5.	Sauvanet A, Boher JM, Paye F, et al. Severe jaundice increases early severe morbidity and decreases long-term survival after pancreaticoduodenectomy for pancreatic adenocarcinoma. J Am Coll Surg, 2015, 221(2): 380-389.
6.	Csendes A, Fernandez M, Uribe P. Bacteriology of the gallbladder bile in normal subjects. Am J Surg, 1975, 129(6): 629-631.
7.	Flemma RJ, Flint LM, Osterhout S, et al. Bacteriologic studies of biliary tract infection. Ann Surg, 1967, 166(4): 563-572.
8.	Karsten TM, van Gulik TM, Spanjaard L, et al. Bacterial translocation from the biliary tract to blood and lymph in rats with obstructive jaundice. J Surg Res, 1998, 74(2): 125-130.
9.	Lygidakis NJ, Brummelkamp WH. The significance of intrabiliary pressure in acute cholangitis. Surg Gynecol Obstet, 1985, 161(5): 465-469.
10.	齐明, 周陶然. 胆汁细菌药敏和抗菌药物应用调查. 外科研究与新技术, 2017, 6(1): 5-7.
11.	徐丽娟, 李素娟. 296 份胆汁细菌培养结果分析. 甘肃医药, 2017, 36(4): 290-291.
12.	Negm AA, Schott A, Vonberg RP, et al. Routine bile collection for microbiological analysis during cholangiography and its impact on the management of cholangitis. Gastrointest Endosc, 2010, 72(2): 284-291.
13.	Wang L, Lin N, Xin F, et al. A systematic review of the comparison of the incidence of seeding metastasis between endoscopic biliary drainage and percutaneous transhepatic biliary drainage for resectable malignant biliary obstruction. World J Surg Oncol, 2019, 17(1): 116.
14.	Hu QL, Liu JB, Ellis RJ, et al. Association of preoperative biliary drainage technique with postoperative outcomes among patients with resectable hepatobiliary malignancy. HPB (Oxford), 2020, 22(2): 249-257.
15.	Liu F, Li Y, Wei Y, et al. Preoperative biliary drainage before resection for hilar cholangiocarcinoma: whether or not? A systematic review. Dig Dis Sci, 2011, 56(3): 663-672.
16.	Howard TJ, Yu J, Greene RB, et al. Influence of bactibilia after preoperative biliary stenting on postoperative infectious complications. J Gastrointest Surg, 2006, 10(4): 523-531.
17.	Park JW, Lee JK, Lee KT, et al. How to interpret the bile culture results of patients with biliary tract infections. Clin Res Hepatol Gastroenterol, 2014, 38(3): 300-309.
18.	Suna N, Yıldız H, Yüksel M, et al. The change in microorganisms reproducing in bile and blood culture and antibiotic susceptibility over the years. Turk J Gastroenterol, 2014, 25(3): 284-290.
19.	Schneider J, De Waha P, Hapfelmeier A, et al. Risk factors for increased antimicrobial resistance: a retrospective analysis of 309 acute cholangitis episodes. J Antimicrob Chemother, 2014, 69(2): 519-525.
20.	Illés D, Urbán E, Lázár A, et al. Changes in antibiotic resistance in cholangitis. Our clinical experience. Orv Hetil, 2019, 160(36): 1437-1442.

1. An Z, Braseth AL, Sahar N. Acute cholangitis: causes, diagnosis, and management. Gastroenterol Clin North Am, 2021, 50(2): 403-414.
2. Parıldar Z, Çınar C, Barutçuoğlu B, et al. Effects of percutaneous transhepatic biliary drainage on renal function in patients with obstructive jaundice. Diagn Interv Radiol, 2011, 17(1): 74-79.
3. Kimmings AN, van Deventer SJ, Obertop H, et al. Endotoxin, cytokines, and endotoxin binding proteins in obstructive jaundice and after preoperative biliary drainage. Gut, 2000, 46(5): 725-731.
4. Pavlidis ET, Pavlidis TE. Pathophysiological consequences of obstructive jaundice and perioperative management. Hepatobiliary Pancreat Dis Int, 2018, 17(1): 17-21.
5. Sauvanet A, Boher JM, Paye F, et al. Severe jaundice increases early severe morbidity and decreases long-term survival after pancreaticoduodenectomy for pancreatic adenocarcinoma. J Am Coll Surg, 2015, 221(2): 380-389.
6. Csendes A, Fernandez M, Uribe P. Bacteriology of the gallbladder bile in normal subjects. Am J Surg, 1975, 129(6): 629-631.
7. Flemma RJ, Flint LM, Osterhout S, et al. Bacteriologic studies of biliary tract infection. Ann Surg, 1967, 166(4): 563-572.
8. Karsten TM, van Gulik TM, Spanjaard L, et al. Bacterial translocation from the biliary tract to blood and lymph in rats with obstructive jaundice. J Surg Res, 1998, 74(2): 125-130.
9. Lygidakis NJ, Brummelkamp WH. The significance of intrabiliary pressure in acute cholangitis. Surg Gynecol Obstet, 1985, 161(5): 465-469.
10. 齐明, 周陶然. 胆汁细菌药敏和抗菌药物应用调查. 外科研究与新技术, 2017, 6(1): 5-7.
11. 徐丽娟, 李素娟. 296 份胆汁细菌培养结果分析. 甘肃医药, 2017, 36(4): 290-291.
12. Negm AA, Schott A, Vonberg RP, et al. Routine bile collection for microbiological analysis during cholangiography and its impact on the management of cholangitis. Gastrointest Endosc, 2010, 72(2): 284-291.
13. Wang L, Lin N, Xin F, et al. A systematic review of the comparison of the incidence of seeding metastasis between endoscopic biliary drainage and percutaneous transhepatic biliary drainage for resectable malignant biliary obstruction. World J Surg Oncol, 2019, 17(1): 116.
14. Hu QL, Liu JB, Ellis RJ, et al. Association of preoperative biliary drainage technique with postoperative outcomes among patients with resectable hepatobiliary malignancy. HPB (Oxford), 2020, 22(2): 249-257.
15. Liu F, Li Y, Wei Y, et al. Preoperative biliary drainage before resection for hilar cholangiocarcinoma: whether or not? A systematic review. Dig Dis Sci, 2011, 56(3): 663-672.
16. Howard TJ, Yu J, Greene RB, et al. Influence of bactibilia after preoperative biliary stenting on postoperative infectious complications. J Gastrointest Surg, 2006, 10(4): 523-531.
17. Park JW, Lee JK, Lee KT, et al. How to interpret the bile culture results of patients with biliary tract infections. Clin Res Hepatol Gastroenterol, 2014, 38(3): 300-309.
18. Suna N, Yıldız H, Yüksel M, et al. The change in microorganisms reproducing in bile and blood culture and antibiotic susceptibility over the years. Turk J Gastroenterol, 2014, 25(3): 284-290.
19. Schneider J, De Waha P, Hapfelmeier A, et al. Risk factors for increased antimicrobial resistance: a retrospective analysis of 309 acute cholangitis episodes. J Antimicrob Chemother, 2014, 69(2): 519-525.
20. Illés D, Urbán E, Lázár A, et al. Changes in antibiotic resistance in cholangitis. Our clinical experience. Orv Hetil, 2019, 160(36): 1437-1442.

West China Medical Journal

Analysis of bile bacterial spectrum and drug resistance in different biliary diseases

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content