Keywords
Cholecystectomy
Prophylactic antibiotics
How to Cite
Abstract
Introduction: Cholecystectomy is a frequently performed operation for symptomatic cholelithiasis. The presence of
gallstones is associated with the bacterial colonization of the bile.
Objectives: The objective of this study is to access the pattern of bacterial isolates from bile aspirates from cholecystectomy
patients and also to determine antibiogram of isolated organisms.
Methodology: A descriptive cross-sectional study was conducted among 140 patients who underwent cholecystectomy
from 1st October 2024 to 31st December 2024 at Kathmandu Medical College and Teaching Hospital after approval from
Institutional Review Committee. Bile samples received from all the patients who underwent cholesystectomy were
included in this study while samples from other illness were excluded. Intra operatively, bile was aspirated from gall
bladder and sent for culture and antibiotic sensitivity testing.
Result: A total of 33(24%) patient's bile was culture positive. Escherichia coli 18 (54%) was the most common isolates
followed by Psedomonas aeruginosa 6(18%), Klebsiella pneumoniae 4(12%), Klebsiella oxytoca 3(9%) and Acinetobacter
baumanii 2(6%) respectively. Most of the isolates were sensitive to Amikacin, piperacillin /Tazobactam and Meropenem.
Conclusion: Escherichia coli was the most common isolates followed by Pseudomonas aeruginosa. Amikacin, Meropenem
and Piperacillin/Tazobactem were sensitive to most of the organisms except for Acinetobacter baumanii which showed
resistant to theses antibiotics.
References
Gupta J, Gupta A, Gupta R, Gupta A, Devkaran B. Bacteriological profile of bile and antibiogram in cholecystectomy patients. J Med Sci Clin Res. 2017 Apr 5;20786–9. [Full Text | DOI]
Randi G, Franceschi S, La Vecchia C. Gallbladder cancer worldwide: geographical distribution and risk factors. Internat J Cancer. 2006 Apr ;118(7):1591- 602. [Full Text | DOI]
Nandakumar A, Gupta PC, Gangadharan P, Visweswara RN, Parkin DM. Geographic pathology revisited: development of an atlas of cancer in India. Internat J Cancer. 2005 Sep;116(5):740-54. [Full Text | DOI]
Srivastava K, Srivastava A, Sharma KL, Mittal B. Candidate gene studies in gallbladder cancer: a systematic review and meta-analysis. Mutation Research/Reviews in Mutation Research. 2011 Jul ;728(1-2):67-79. [Full Text | DOI]
Hamdani NH, Qadri SK, Aggarwalla R, Bhartia VK, Chaudhuri S, Debakshi S. Clinicopathological study of gall bladder carcinoma with special reference to gallstones: our 8-year experience from eastern India. Asian Pacific J Cancer Prevention. 2012;13(11):5613- 7. [Pub Med | Full Text | DOI]
Tyagi BB, Manoharan N, Raina V. Risk factors for gallbladder cancer: A population-based case-control study in Delhi. Ind J Med Paediatr Oncol. 2008 Jan ;29(1):16. [Full Text]
Lee JG. Diagnosis and management of acute cholangitis. Nat Rev Gastroenterol Hepatol. 2009 Aug;6(9):533-41. [Pub Med | Full Text | DOI]
CLSI. Performance Standards for Antimicrobial Disk Susceptibility Tests. 14th ed. 2024. [Full Text]
Ahmad F, Islahi S, Hingora OM, Singh YI. Cholelithiasis a clinical and microbiological analysis. Int J Scientific Study. 2014 Jul ;2(4):40-5. [Full Text]
Sattar I, Aziz A, Rasul S, Mehmood Z, Khan A. Frequency of infection in cholelithiasis. J Coll Physicians Surg Pak. 2007 Jan;17(1):48-50. [Pub Med | Full Text | DOI]
Shrestha KR, Adhikary S, Koirala R, Amatya R. Frequency of bile bacteria in gallstone disease. J Institute Med. 2014 Apr;36(1):34-7. [Full Text | DOI]
Viral Patel and Ashvin kankotiya. “Bacteriological analysis of bile in cholecystectomy patients.” Int J Current Research. 2020 Apr ;12(4) :11191-6. [Full Text | DOI]
Shankaran R, Amarasekara C. A prospective observational study to study and correlate the clinical and microbiological profile of bile cultures in patients with symptomatic cholelithiasis. Int Surg J. 2020 May;7(5):1566-9. [Full Text | DOI]
Morris-Stiff GJ, O'Donohue P, Ogunbiyi S, Sheridan WG. Microbiological assessment of bile during cholecystectomy: is all bile infected? HPB (Oxford). 2007;9(3):225-8. [Pub Med | Full Text | DOI]
Ahmad M, Akhtar MR, Ali A, Ahmad A, Hashmi JS. Microbiology of bile in symptomatic uncomplicated gallstone disease. Pak Armed Forces Med J. 2015 Aug;65(4):491-3. [Full Text]
Stewart L, Smith AL, Pellegrini CA, Motson RW, Way LW. Pigment gallstones form as a composite of bacterial microcolonies and pigment solids. Ann Surg 1987 Sep;206(3): 242-50. [Pub Med | Full Text | DOI]
Ohdan H, Oshiro H, Yamamoto Y, Tanaka I, Inagaki K, Sumimoto K, et al. Bacteriological investigation of bile in patients with cholelithiasis. Surg Today 1993;2 3:390-395. [Pub Med | Full Text | DOI]