Bile culture and drug resistance analysis in patients with hepatobiliary disease complicated with biliary tract infection

Abstract

Objective To analyze the results of the bile culture and drug sensitivity test in patients with hepatobiliary disease complicated with biliary tract infection to provide reference for clinical use of antibiotics. Methods One hundred and thirty-six patients who were diagnosed with hepatobiliary disease complicated with biliary tract infection in Zhongshan Hospital of Sun Yat-sen University from January 2015 to August 2016 were enrolled in this prospective study. There were 83 males and 53 females with a mean age of (43±10) years old. The informed consents of all patients were obtained and the local ethical committee approval was received. The bile specimens from all patients were collected for bacterial and fungal culture and drug resistance analysis was performed. Results A total of 136 pathogens were isolated and cultured, including 69.8% of gram-negative pathogens, 28.7% of gram-positive pathogens and 1.5% of fungi. The most prevalent five pathogens were Escherichia coli (35.3%), Klebsiella pneumonia (14.0%), Enterococcus faecalis (12.5%), Enteroccocus faecium (9.6%) and Pseudomonas aeruginosaranked (8.0%). Low resistance to carbapenems was observed in gram-negative pathogens. Gram-positive pathogens revealed highly sensitive to vancomycin, linezolid and tigecycline, whereas less sensitive to erythrocin and clindamycin. Candida albicans revealed highly sensitive to itraconazole and fluconazole. Conclusions Gram-negative pathogens are the dominant pathogens in biliary tract infection, but the proportion of gram-positive pathogens significantly increases. The antibiotic drugs should be selected reasonably according to the results of drug sensitivity test in the clinical teatment to reduce the drug resistance of pathogens and raise the cure rate. Key words: Biliary tract disease; Infection; Microbial sensitivity tests