Gangrenous cholecystitis and acute cholangitis associated with anaerobic bacteria in bile

Marne, C; Pallarés, Román; Martin, Ralph M.; Sitges-Serra, A.

doi:10.1007/bf02013458

Cited by 30 publications

(25 citation statements)

References 16 publications

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“…These findings indicated that Enterobacteriaceae might be the primary causative organisms of AC. In agreement with our findings, other studies have implicated several genera of Enterobacteriaceae, including E. coli, Klebsiella pneumonia, Salmonella, to be the main pathogenic bacteria in bile flora[8, 43,44].A strong correlation between the quantities of Enterobacteriaceae existing in the gut and bile flora was also found. According to the data fromAlmeida et al, E. coli infection can degrade intestinal barrier and thereby compromise its integrity[45].…”

supporting

confidence: 91%

Acute cholecystitis associated with infection of Enterobacteriaceae from gut microbiota

Liu

Yan

Luo

et al. 2015

Clinical Microbiology and Infection

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Acute cholecystitis (AC) is one of the most common surgical diseases. Bacterial infection accounts for 50% to 85% of the disease's onset. Since there is a close relationship between the biliary system and the gut, the aims of this study were to characterize and determine the influence of gut microbiota on AC, to detect the pathogenic microorganism in the biliary system, and to explore the relationship between the gut and bile microbiota of patients with AC. A total of 185 713 high-quality sequence reads were generated from the faecal samples of 15 patients and 13 healthy controls by 16S rRNA gene pyrosequencing. Patients' samples were significantly enriched in Akkermansia, Enterobacter and Escherichia/Shigella group. The healthy controls, however, showed significant enrichment of Clostridiales, Coprococcus, Coprobacillaceae, Paraprevotella, Turicibacter and TM7-3 in their faecal samples. Escherichia coli was the main biliary pathogenic microorganism, among others such as Klebsiella spp., Clostridium perfringens, Citrobacter freundii and Enterobacter cloacae in the bile of the patients. Additionally, the amount of bile endotoxin significantly correlated with the number of Enterobacteriaceae, especially E. coli. Our data indicate that Enterobacteriaceae might play essential role in the pathogenesis and/or progress of AC. This was verified in an in vivo model using a pathogenic E. coli isolated from one of the patients in guinea pigs and observed marked gallbladder inflammation and morphologic changes. This study thus provides insight which could be useful for the prevention, diagnosis and treatment of AC and related diseases by controlling the growth of Enterobacteriaceae to alleviate the infection.

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supporting

confidence: 91%

Acute cholecystitis associated with infection of Enterobacteriaceae from gut microbiota

Liu

Yan

Luo

et al. 2015

Clinical Microbiology and Infection

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“…Biliary penetration of antibiotic agents should be considered as well, but is less important than efficacy against suspected bacteria. The clinical context also must be appreciated, because it has been shown that anaerobic bacteria are found more frequently in severe cholangitis than in mild cases [28][29][30]. Similarly, hospital-acquired cholangitis is often caused by multiple and/or resistant organisms, such as Pseudomonas spp, methicillin-resistant Staphylococcus aureus, and vancomycin-resistant enterococci, whereas the infection in community-acquired cases is mostly caused by a single species of intestinal microorganism, such as E. coli, Klebsiella, and Enterococcus spp.…”

Section: Therapeutic Managementmentioning

confidence: 99%

Diagnosis and Management of Acute Cholangitis

Mosler

2011

Curr Gastroenterol Rep

111

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Acute cholangitis is a potentially life-threatening systemic disease resulting from a combination of infection and obstruction of the biliary tree, secondary to different underlying etiologies. Common causes of cholangitis (eg, gallstones, benign and malignant biliary strictures) are well known. However, others (eg, immunoglobulin-G subclass-4-related sclerosing cholangitis) have been described only recently, are still under evaluation, and need to gain broader attention from clinicians. The diagnosis of acute cholangitis is based on clinical presentation and laboratory data indicating systemic infection, as well as diagnostic imaging modalities revealing signs of biliary obstruction and possibly an underlying etiology. The clinical presentation varies, and initial risk stratification is important to guide further management. Early medical therapy, including fluid resuscitation and appropriate antibiotic coverage, is of major importance in all cases, followed by a biliary drainage procedure and, if possible, definitive therapy of the underlying etiology. The type and timing of biliary drainage should be based on the severity of the clinical presentation, and the availability and feasibility of drainage techniques, such as endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC), and open surgical drainage. ERCP plays a central role in the management of biliary obstruction in patients with acute cholangitis. Endoscopic ultrasound-guided biliary drainage recently emerged as a possible alternative to PTC for second-line therapy if ERCP fails or is not possible.

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“…Since the empirical antibiotic is only a bridge to the proper treatment, which is based on the culture results, it is important to select an effective empirical antibiotic. Many cholangitis patients with positive blood cultures have been found to have the same bacteria in their blood as those isolated from the bile cultures [41,42]. Therefore, microbial information gathered from bile cultures should provide valuable therapeutic guidance.…”

Section: Discussionmentioning

confidence: 99%

Changing trend in bile microbiology and antibiotic susceptibilities: over 12 years of experience

et al. 2012

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In contrast to earlier reports, we found that Enterococcus has emerged as the most frequently isolated microorganism from bile. The importance of enterococcal infection should be recognized, and currently recommended antibiotics need to be re-evaluated since in our bile cultures most provided inadequate coverage for the more frequently encountered microorganisms. The changes in the trends of microorganisms isolated from bile should be considered in cases where patients present with biliary obstruction.

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Gangrenous cholecystitis and acute cholangitis associated with anaerobic bacteria in bile

Cited by 30 publications

References 16 publications

Acute cholecystitis associated with infection of Enterobacteriaceae from gut microbiota

Acute cholecystitis associated with infection of Enterobacteriaceae from gut microbiota

Diagnosis and Management of Acute Cholangitis

Changing trend in bile microbiology and antibiotic susceptibilities: over 12 years of experience

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