Gram staining of gallbladder bile samples is useful for predicting surgical site infection in acute cholecystitis patients undergoing an early cholecystectomy

Nishida, Yasunori; Otagiri, Noriaki; Yoshifuku, Seijiro; Momose, Kazutaka; Ko, Kenju; Sasahara, Kotaro; Mishima, Osamu; Tauchi, Katsunori

doi:10.1002/jhbp.790

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…The perprotocol analysis revealed a significantly higher rate of organ or space infections in the no-prophylaxis group. Multivariable analysis showed that omitting antibiotic prophylaxis and a positive bile culture were associated with surgical-site infections, in line with previous studies 22,23 .…”

Section: Discussionsupporting

confidence: 89%

Antibiotic prophylaxis for acute cholecystectomy: PEANUTS II multicentre randomized non-inferiority clinical trial

Braak

Ponten

Loozen

et al. 2022

British Journal of Surgery

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Background Guidelines recommending antibiotic prophylaxis at emergency cholecystectomy for cholecystitis were based on low-quality evidence. The aim of this trial was to demonstrate that omitting antibiotics is not inferior to their prophylactic use. Methods This multicentre, randomized, open-label, non-inferiority clinical trial randomly assigned adults with mild-to-moderate acute calculous cholecystitis (immediate cholecystectomy indicated) to 2 g cefazolin administered before incision or no antibiotic prophylaxis. The primary endpoint was a composite of all postoperative infectious complications in the first 30 days after surgery. Secondary endpoints included all individual components of the primary endpoint, other morbidity, and duration of hospital stay. Results Sixteen of 226 patients (7.1 per cent) in the single-dose prophylaxis group and 29 of 231 (12.6 per cent) in the no-prophylaxis group developed postoperative infectious complications (absolute difference 5.5 (95 per cent c.i. −0.4 to 11.3) per cent). With a non-inferiority margin of 10 per cent, non-inferiority of no prophylaxis was not proven. The number of surgical-site infections was significantly higher in the no-prophylaxis group (5.3 versus 12.1 per cent; P = 0.010). No differences were observed in the number of other complications, or duration of hospital stay. Conclusion Omitting antibiotic prophylaxis is not recommended.

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Section: Discussionsupporting

confidence: 89%

Antibiotic prophylaxis for acute cholecystectomy: PEANUTS II multicentre randomized non-inferiority clinical trial

Braak

Ponten

Loozen

et al. 2022

British Journal of Surgery

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“…This high morbidity rate is partly due to SSIs, which are reported to occur in 10% of cholecystectomies. [7][8][9] The high incidence of SSIs is suspected due to pathogen contamination of the bile fluid in the surgical incision and organ space. Positive culture bile culture correlate with an increased risk of postoperative infection.…”

mentioning

confidence: 99%

Surgical site infections: a cross-sectional study of bile culture

Saadhi,

Budhi,

Soewoto

et al. 2023

Int Surg J

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Background: Surgical site infections (SSIs) are one of the most common reported healthcare-associated infections worldwide. SSIs are also the most common complication of various surgical procedures, including cholecystectomy which is the standard surgical procedure for calculus cholecystitis. The association between SSIs and cholecystectomy is suspected due to infection from pathogens in the bile. This study aims to determine the relationship between bile culture results and the incidence of SSIs in patients with calculus cholecystitis undergoing cholecystectomy procedures. Methods: This study was an analytic observational study with a cross-sectional design which involved 44 subjects. The data obtained were then analyzed using the Chi square method with the IBM statistical package for the social sciences (SPSS) version 26. Results: There were 44 subjects with calculus cholecystitis included in this study. None of the subjects in this study had SSIs, and also 54.5% of the subjects were given postoperative antibiotics. The results of data analysis showed no significant association between bile culture and SSIs (p>0.05). Additional analysis in this study also revealed no association between type of surgery and bile culture (p>0.05) and between postoperative antibiotic administration and SSIs (p>0.05). Conclusions: Positive bile culture was not associated with the incidence of SSIs in calculus cholecystitis patients undergoing cholecystectomy procedures. The findings of this study also revealed no association between type of surgery and SSIs and postoperative antibiotic administration is not a mandatory for every cholecystectomy procedure.

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Intraoperative bile spillage as a risk factor for surgical site infection: a propensity score-matched NSQIP analysis

et al. 2022

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Gram staining of gallbladder bile samples is useful for predicting surgical site infection in acute cholecystitis patients undergoing an early cholecystectomy

Cited by 5 publications

References 19 publications

Antibiotic prophylaxis for acute cholecystectomy: PEANUTS II multicentre randomized non-inferiority clinical trial

Antibiotic prophylaxis for acute cholecystectomy: PEANUTS II multicentre randomized non-inferiority clinical trial

Surgical site infections: a cross-sectional study of bile culture

Intraoperative bile spillage as a risk factor for surgical site infection: a propensity score-matched NSQIP analysis

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