Microbial profile and antibiotic sensitivity pattern in acute bacterial cholangitis

Sahu, Manoj Kumar; Chacko, Ashok; Dutta, Amit Kumar; Prakash, John Antony Jude

doi:10.1007/s12664-011-0135-3

Cited by 33 publications

(53 citation statements)

References 20 publications

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“…Most studies have reported Escherichia and Klebsiella to be the most frequently identified microorganisms in bile [2,3,[8][9][10][11][12][13][14][15][16][17]. However, more recent studies have indicated that Enterococcus is becoming more predominant [18][19][20][21][22] and, in accordance with these reports, we found that Enterococcus was the most commonly isolated organism in our study.…”

Section: Discussionsupporting

confidence: 90%

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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Section: Discussionsupporting

confidence: 90%

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

et al. 2012

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“…This reproduction rate was not surprising because contamination of the biliary system is well-known in patients who have sphincterotomy or a placed stent. In past studies, 16%-85% reproduction was determined (4,(8)(9)(10)(11)(12)(13)(14). In older studies, 30%-90%polymicrobial reproduction in bile cultures was determined, especially in patients whose bile ducts had previous interference (15)(16)(17)(18)(19).…”

Section: Discussionmentioning

confidence: 99%

“…Blood cultures provide an opportunity to determine effective organisms. In past studies, in patients with cholangitis, reproduction in blood cultures was reported as 20%-80% (14,15,(23)(24)(25)(26)(27). The low reproduction rates in our blood cultures could have been because cases that did not have cholangitis were included in the study.…”

Section: Discussionmentioning

confidence: 99%

The change in microorganisms reproducing in bile and blood culture and antibiotic susceptibility over the years

Suna

Yıldız²,

Yüksel³

et al. 2014

Turk J Gastroenterol

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Background/Aims: Infection in the bile tract is a major cause of bacteremia and is related to high morbidity and mortality. We examined the changes in bacteria types and antibiotic susceptibility in bile cultures and simultaneous blood cultures taken from patients who applied for endoscopic retrograde cholangio pancreatography (ERCP)/ percutaneous transhepatic cholangiography (PTC) for different bile duct diseases in recent years. Materials and Methods: Bacteria types that reproduce in bile and blood cultures from patients who applied for ERCP/PTC between the years of 2007 and 2012 in our clinic were examined. All patients were evaluated together, and in addition, the periods between 2007 and 2009 (Group 1) and between 2010 and 2012 (Group 2) were compared. Results: In total, 550 patients applied to this study. There were 266 patients in Group 1 and 284 in Group 2. Reproduction occurred in 77.6% of bile cultures. In the order of frequency, these cultures consisted of Escherichia coli (32.8%), Enterococcus spp. (26.2%), and Pseudomonas aeruginosa (11%). Enterococcus spp. were determined to be higher in Group 2 than Group 1 (p<0.016). Resistance to quinolones was found in 74.1% of patients, to ampicillin in 73.2%, and to cephalosporins in an average of 61%. Vancomycin was the most susceptible antibiotic (93.4%) to gram-positives. Resistance to piperacillin-tazobactam and amikacin was higher in Group 2 than Group 1 (p=0.001 and p=0.003, respectively). Conclusion:The most frequently reproducing bacteria in the bile cultures evaluated in our hospital were Escherichia coli and Enterococcus spp. Although it was thought that the antibiotics given empirically were effective against these bacteria, there was resistancerate of 75% in our study. We determined that the first-and second-step treatment protocols must be updated.

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“…A χ 2 test was performed to analyze associations between men and women, the presence of a gallbladder stone and a history of cholecystectomy in the CBDdil(-) and CBDdil(+) groups. One-way analysis of variance followed by a Tukey's post hoc test was used to compare the age of patients and laboratory test variables between the CBDdil(-) and CBDdil(+) groups.…”

Section: Discussionmentioning

confidence: 99%

“…However, not all patients with acute cholangitis meet the Charcot's triad criteria (12). Therefore, when patients did not meet the Charcot's triad criteria but were suspected of having acute cholangitis with or without common bile duct dilatation MINORU TOMIZAWA 1 , FUMINOBU SHINOZAKI 2 , RUMIKO HASEGAWA 3 , YOSHINORI SHIRAI 3 , YASUFUMI MOTOYOSHI 4 , TAKAO SUGIYAMA 5 , SHIGENORI YAMAMOTO 6 and NAOKI ISHIGE 7 Departments of 1 Gastroenterology, 2 Radiology, 3 Surgery, cholangitis, they were evaluated according to the Tokyo guidelines (9). A total of 17 patients were diagnosed with acute cholangitis according to the Charcot's triad, while 60 patients were diagnosed based on the TG13.…”

Section: Diagnosis and Management Of Acute Cholangitismentioning

confidence: 99%

Comparison of acute cholangitis with or without common bile duct dilatation

Tomizawa

Shinozaki

Hasegawa

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. To improve the management of patients with acute cholangitis, the present study compared laboratory test variables between acute cholangitis patients with or without common bile duct (CBD) dilatation [CBDdil(+) and CBDdil(-), respectively]. The medical records of patients diagnosed with acute cholangitis and subjected to endoscopic retrograde cholangiopancreatography between February 2008 and May 2015 were retrospectively analyzed. The present study consisted of 40 men (aged 69.4±8.8 years) and 37 women (aged 68.8±11.6 years). It was observed that CBDdil(-) patients were slightly younger than CBDdil(+) patients (P=0.0976), and levels of C-reactive protein (CRP) were significantly higher in CBDdil(-) patients than in CBDdil(+) patients (P=0.0392). In addition, logistic regression analysis indicated that CRP levels were associated with the presence of CBD dilatation (P=0.0392). These data indicate that patients with acute cholangitis without CBD dilatation tend to be younger and have higher levels of CRP. Thus, in acute cholangitis patients without CBD dilatation, diagnosis should be determined using clinical symptoms and laboratory data.

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Microbial profile and antibiotic sensitivity pattern in acute bacterial cholangitis

Abstract: Changing antimicrobial sensitivity patterns requires a revision of empiric antibiotic therapy policy in cholangitis.

Cited by 33 publications

References 20 publications

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

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

The change in microorganisms reproducing in bile and blood culture and antibiotic susceptibility over the years

Comparison of acute cholangitis with or without common bile duct dilatation

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