Prospective Study On Biliary Bacteriology In Calcular Disease Of The Gall Bladder And The Role Of Common Newer Antibiotics

Abstract

Objective: To study:• The various bacterial pathogens isolated from bile obtained during surgery.• The difference in the bacterial profile of organisms grown from bile collected during surgery for acute cholecystitis and comparison with those undergoing elective cholecystectomy for chronic cholecystitis.• The antibacterial sensitivity of newer antibiotics on the organisms isolated from the bile of patients with gallbladder stone disease undergoing cholecystectomy. Method: This prospective study which was conducted in the Acharya Shri Chander College of Medical Sciences and Hospital, Sidhra, Jammu, comprised 150 consecutive patients and included both open as well as laparoscopic cholecystectomy. Samples, about 3-5 ml of bile, were collected and transported to the microbiology laboratory for further studies. Gram staining, aerobic and anaerobic cultures were done and antimicrobial sensitivity was tested. Results: Escherichia coli (53.84%) was one of the most common isolated bacteria followed by Pseudomonas aeruginosa (26.92%) and Staphylococcus aureus (19.23%). The resistance to second generation cephalosporins has increased with time, while the bile showed sensitivity to thirdand fourth-generation cephalosporins, Conclusion: Positive bile culture was a common finding in patients with acute cholecystitis in this study. Escherichia coli was one of the most common isolated bacteria followed by Pseudomonas aeruginosa and Staphylococcus aureus. The resistance to second-generation cephalosporins has increased while thirdand fourth-generation cephalosporins show better promise and may be used as the first line of preoperative prophylaxis in operations for gallbladder stone disease.