Laparoscopic cholecystectomy is the most commonly performed routine surgical operation in general surgery. There is a debate about utility of prophylactic antibiotic therapy following cholecystectomy. The aim of the study was to investigate bacterial growth in bile culture from patients after laparoscopic cholecystectomy. Methods. This study included 80 patients who undergone laparoscopic cholecystectomy. All gallbladder specimens were sent for histopathology. A bile sample from each case was cultured on Brain heart infusion broth, MacConkey agar, and chocolate agar. Analytical profile indices were used for identification of isolated bacteria. Results. Six histopathological abnormalities were detected, of which chronic cholecystitis was the most common abnormality (58.75%) followed by acute cholecystitis with mucocele (11.25%). Thirty one bile samples (38.75%) were positive for bacterial growth. The overall bacterial isolates from bile samples showed Escherichia coli, 13.75%, Pseudomonas aeruginosa, 8.75%, Enterococcus faecium, 5%, Citrobacter freundii, 3.7%, Staphylococcus epidermidis, 3.75%, Lactobacillus gasseri, 2.5% and Bifiidobacterium, 1.25%. Bacterial colonization of gallbladder was significantly associated with acute cholecystitis with mucocele and empyema. Conclusions. More than one third of patients with cholelithiasis are positive for bacterial culture. Bacterial infection of stoned gallbladder associated with the development of empyema. Thus, prophylactic antibiotic therapy is recommended for patients undergoing cholecystectomy due to gallbladder stone.
Frequent relapse occurs in about 60% of children with steroid-sensitive nephrotic syndrome (SSNS) despite the tangible initial response. Several factors have been documented as triggers for frequent relapses (FR). However, the role of urinary tract infection (UTI) was not well-illustrated. Our aim was to evaluate the role of UTI as a trigger for FR among Iraqi children SSNS. This cross-sectional study was conducted on a total of 68 children with the first episode of SSNS who were followed up for 6 months after taking their treatment for the first episode. The patients were divided into two groups: frequent and infrequent relapse. Midstream urine samples were collected from each child and routine bacteriological culture and detection were achieved. Data regarding age at onset, sex, steroid therapy at the onset, the time between the onset and first relapse were collected from patients' records. The proportion of frequent relapses was 41.18%. UTI affected 22 (32.35%) patients with E. coli was the most common isolated bacteria accounting for 63.64% followed by Klebsiella pneumonia (18.18%), Proteus spp. and Pseudomonas aeruginosa (13.64% for each). In univariate analysis, each of age at onset, inadequate therapy for the first episode, and UTI were significantly associated with frequent relapse. However, in multivariate analysis, only adequate treated for first episode (OR= 0.26, 95%CI= 0.08-0.86, p= 0.028) and UTI (OR= 4.8, 95%CI= 1.22-18.87, p= 0.025) were significantly associated. In conclusion, UTI is an important cause of FR in children with SSNS. Therefore, affected children should be routinely investigated for such infection.
A ureteral stent is most broadly used to manage upper urinary tract disorders such as obstruction and prevent post-endoscopic complications. However, the stent may become a niche for bacterial colonization. This study aimed to determine the rate of bacterial colonization and type of bacteria in internal ureteral stents and the risk factors associated with bacterial colonization. This prospective cross-sectional study included 100 consecutive adult patients who had temporary ureteral stenting as preparation for a secondary ureterorenoscopy at Al-Yarmook Hospital/ Baghdad. All included patients were negative for bacterial culture before stenting. Stent and urine culture were performed at the time of stent removal. The colonization rate and bacteriuria in patients with internal ureteral stent were 19% and 9%, respectively. The most common bacteria in-stent and urine were E. coli accounting for 31.58% and 33.33%. Pseudomonas aeruginosa was common in stent culture, representing 21.05%. Positive bacterial culture was confirmed in 19 stents and 9 urine samples. All cases with positive urine samples were also positive for culture. Thus, the sensitivity and specificity of urine culture for detection of stent colonization were 47.37% and 100%, respectively. Diabetes mellitus, chronic renal failure, and prolonged stenting were significantly associated with increased stent colonization. The ureteral stent could be a source of urinary tract infection. The most pathogenic bacteria associated with the ureter stent are E. coli and Pseudomonas aeruginosa. Risk factors associated with stent colonization are diabetes mellitus, chronic renal failure, and prolonged indwelling time.
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