Microbiological Examinations and In-Vitro Testing of Different Antibiotics in Therapeutic Endoscopy of the Biliary System

Abstract

Escherichia coli was found to be the pathogen most frequently detected in blood and bile following endoscopic interventions in the biliary tract. Enterococci, Klebsiella and Streptococcus viridans were found in bile cultures with an incidence exceeding 10%. In view of the in-vitro test results, possible side effects, and contraindications, amoxicillin plus beta-lactamase inhibitors or quinolones are considered to be suitable antibiotics for the prophylaxis of biliary infections.

Microbial profile and antibiotic sensitivity pattern in acute bacterial cholangitis

“…The prospective arm of our study showed that GNB had high resistance to ampicillin, ciprofloxacin and third generation cephalosporins. A high sensitivity of GNB to imipenem was observed in our study as documented in other studies [6,9,15,17]. Enterococcus, the predominant gram positive isolate, had high resistance to ciprofloxacin but good sensitivity to vancomycin and teicoplanin.…”

“…Another study from Taiwan on 112 patients with cholangitis showed CBD stones were responsible in 54.6% of cases and malignancy in 25% [7]. The incidence of cholangitis in malignant obstruction is on the rise because of the frequent use of endoscopic/radiological biliary drainage procedures [3,9]. One-third of our patients with malignant biliary obstruction had a prior history of ERCP.…”

Clinical Determinants for the Recovery of Fungal and Mezlocillin‐Resistant Pathogens from Bile Specimens

“…Exclusion of these isolates or stratification by clinical diagnosis did not substantially alter the species distribution (data not shown), although lower prevalences of P. aeruginosa (1%) and Candida species (6%) were noted for isolates that were obtained from patients with cholecystitis. Table 1 summarizes the distribution of species and compares that distribution to data published elsewhere [5,6,[9][10][11][12][13][14][15][16]. Table 2 shows a pooled analysis of the isolates' susceptibility to antibiotics commonly used to treat biliary infections.…”

Antibioprophylaxie en endoscopie digestive

“…Les principaux facteurs de risque rencontrés sont les pseudo-kystes pancréatiques, les cancers du hile et les sténoses néoplasiques de la voie biliaire, la pression d'injection qui favorise la translocation bactérienne, la qualité du drainage biliaire (seul facteur identifié en analyse multivariée), et la durée d'hospitalisation [11][12][13].…”