Abstract
Background
Gallbladder and biliary tract infections are diseases with high mortality rates if they are not treated properly. Microbiological evaluation of perioperatively collected samples both ensures proper treatment of patients and guides empirical treatment due to the determination of microorganism susceptibility.
Aims
This study aimed to isolate the microorganisms in bile cultures from patients who underwent cholecystectomy and to determine sensitivity results of these microorganisms.
Methods
This study was a multi-center and prospective design, included 360 patients, and was performed between 2019 and 2020. Culture results of bile taken during cholecystectomy were evaluated.
Results
Bacterial growth was found in the bile cultures of 84 out of 360 (23.3%) patients. Patients were divided into two groups according to whether they had risk factors for resistant microorganisms or not. While Escherichia coli (n = 11, 13%), Enterococcus spp. (n = 8, 9.5%), and Enterobacter spp. (n = 4, 4.7%) were detected most frequently in patients without risk. Staphylococcus spp. (n = 17, 20.2%), Enterococcus spp. (n = 16, 19%), and E. coli (n = 8, 9.5%) were the most frequently found microorganism at-risk patients. In multivariate analysis, bile culture positivity was found higher in patients who had history of biliary disease (p = 0.004), operation performed concurrently with a cholecystectomy (p = 0.035), and high rate of polymorphonuclear leukocytes (PNL) in total leukocyte count (p = 0.001).
Conclusions
Our study shows that when starting empirical antibiotic treatment for bile ducts, whether patients are at risk for the development of resistant bacterial infection should be evaluated after which antibiotic selection should be made accordingly.
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Data availability
The datasets for the this study are available from the corresponding author on reasonable request.
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Supported by Infectious Diseases and Clinical Microbiology Specialty Society of Turkey.
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All the authors (D. Ozturk-Engin, C. Agalar, Y. Cag, F. Kesmez-Can, I. I. Balkan, O. Karabay, S. Senbayrak, B. Meral-Cetinkaya, M.T.Aydın, K. Tomas, E. Disci, A. Surmelioglu, O. Alimoglu, O. Ekinci, E. Akın, M. Köroğlu, M. Velidedeoglu, H. Ankaralı, E. Kocoglu, E. Ozmen, M. Javadov, B. Papilla-Kundaktepe, N. Oguzoglu, R. Donmez, E. Mega, S. Aksaray, F. Agalar) have made significant contributions to the concept or design of the study. Material preparation, data collection, and analysis were performed by these authors. They drafted and critically reviewed to the study. They have contributed to and are responsible for all aspects of his work. The final version of the article has been read and approved by all authors. All named authors have seen and reviewed the submitted version of the paper and agreed to all included data.
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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Fatih Sultan Mehmet Training and Research Hospital in Istanbul, Turkey. Our study was designed prospectively and approval was obtained from the local ethics committee before the study started. The ethics committee document obtained from the ethics committee is attached. Ethics committee document is written in Turkish. However, if requested, we can send it in English. In our study, samples taken preoperatively were examined.
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Ozturk-Engin, D., Agalar, C., Cag, Y. et al. Microorganisms isolated from the bile of the patients who have undergone cholecystectomy and their antibiotic resistance pattern: multicenter prospective study. Int Microbiol 25, 759–767 (2022). https://doi.org/10.1007/s10123-022-00251-y
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DOI: https://doi.org/10.1007/s10123-022-00251-y