Antibiotic susceptibility patterns of isolated bacteria from bile fluids of patients with gallstone disease in Isfahan city (Iran)

Seyed-Masih Fatemi,Abbas Doosti,Reza Moayednia,Hamid Tavakoli,Payam Ghasemi-Dehkordi,Milad Moayednia,Mohsen Mahmudieh,Behrooz Kelidari

doi:10.2298/abs140506021f

Abstract

Bacterial infections are one of the important agents in the creation of gallstones in the gallbladder. In recent years the spread of antibiotic-resistant bacteria such as extended-spectrum ?-lactamases (ESBL) is increasing and of concern in hospitalized patients worldwide. The purpose of this study was to investigate the antibiotic susceptibility patterns of isolated bacteria from the bile specimens of patients with chronic and acute cholecystitis who had been operated by single-incision laparoscopic cholecystectomy (SILC) in Isfahan (Iran) 2 using an antibiogram susceptibility test and molecular technique. The bile fluids of 91 patients were obtained from the Al-Zahra hospital and were cultured on specific media for the isolation of Gram-negative and positive bacteria and the disk diffusion test was done to determine the antibiotic susceptibility patterns of isolated bacteria. Finally, bacterial DNA was extracted from the bile samples and polymerase chain reaction (PCR) was performed to investigate extended-spectrum ?-lactamases genes. The bacteria Escherichia coli, Klebsiella pneumoniae, Proteus spp. and Staphylococcus aureus were detected in bile specimens cultured with high frequency, and the results showed that biliary infection increased with aging in patients with gallstone disease operated by SILC. The results showed a high frequency of ESBL genes including TEM, SHV, and CTX-M in isolated bacteria (especially Escherichia coli and Klebsiella spp.). Thus, evaluating the antibiotic susceptibility patterns and screening of ESBLs bacteria in patients with gallstones are essential. Prescribing suitable drugs, designing good strategies, and informing the medical community could decrease bile infection and antibiotic-resistant bacteria in clinical centers and hospitals.

Highlights

The gallbladder is a sac-like organ located in the upper right of the abdomen, inferior and posterior of the liver
Gallstones develop in the gallbladder or bile duct and can cause sudden pain, infection and inflammation as well as jaundice and fever (Vitetta et al, 2000; Paterson et al, 2005)
The cultures of bile specimens of 91 patients operated by single-incision laparoscopic cholecystectomy (SILC) on specific culture media showed a high-frequency of Gram-negative bacteria including Escherichia coli (E. coli) in 78 cases (85.7%), Klebsiella pneumoniae in 38 cases (41.7%), Proteus spp. in 30 cases (32.96%), Table 3

Summary

Introduction

The gallbladder is a sac-like organ located in the upper right of the abdomen, inferior and posterior of the liver. Gallstones develop in the gallbladder or bile duct and can cause sudden pain (biliary colic), infection and inflammation (acute cholecystitis) as well as jaundice and fever (Vitetta et al, 2000; Paterson et al, 2005). Acute cholecystitis is caused by gallstones in the gallbladder and the symptoms are sudden inflammation of the gallbladder and abdominal pain. The prevalence of gallstone disease varies depending on the geographic region, and in white adults of developed countries and American Indians it is 10-15%, and 60-70%, respectively (Stinton et al, 2010). The frequency of gallstone disease in black Americans, East Asia and sub-Saharan Africa is reduced (Shaffer, 2006). There are few studies available about the frequency of gallstone disease in Iran (Massarrat, 2001). In Iran (2013), 20-50% of the patients with chronic cholecystitis had a positive bile culture for isolated bacteria (Moazeni Bistgani and Imani, 2013)

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