Investigation of the gallbladder for the presence of pathogenic bacteria and their antibiotic susceptibility pattern

Abstract

Background: The gallbladder is an essential organ in the human body that functions as an antioxidant. Cholangitis and pyogenic cholecystitis are two significant reasons for cholecystectomy. The significance of establishing microbial cultures and antibiotic susceptibility is that suitable antibiotics can be supplied because the infection can lead to severe consequences and death if not treated properly. However, very limited data is available on this matter. Therefore, this study is an attempt to investigate the presence of bacterial pathogens causing gallbladder disease and antibacterial susceptibility patterns to assess the choice of antibiotic. Moreover, both gallbladder’s wall and bile samples were investigated for accurate results. None of the past studies have worked on the gallbladder and the bile simultaneously. Objective: A prospective analytical study was conducted from July to December 2014. Blood, MacConkey agar, and Robertson cooked medium were used to culture all the clinical samples. After 24 and 48 hours of incubation, culture plates were examined for evident growth. Standard microbiological procedures were used to identify the isolated species. Antibiotic susceptibility tests were performed, and the isolated bacteria were also examined for extended-spectrum beta-lactamase (ESBL) development. Results: Among 60 patients, 66% were positive for bacteria in the gallbladder wall or bile, or both. Gramnegative bacteria were the most commonly isolated ones. Due to ESBL production, bacteria were mainly resistant to all cephalosporins and Augmentin. However, aminoglycosides, carbapenem, and antibiotics combination were the most effective. Conclusion: It can be concluded that organisms are more resistant now due to ESBL production, so the old regimen of antibiotics might not be effective in treating them. The considerable culture-positive rate highlights the significance of acquiring bile and gallbladder wall bacterial cultures to administer the proper antibiotics at cholecystectomy. To avoid major complications like gram-negative septicemias, necessary adjustments must be made by the results of antibiotic sensitivity tests.