Bacteria Isolated From Patients With Cholelithiasis and Their Antibacterial Susceptibility Pattern

Implication for health policy/practice/research/medical education: Determine the exact incidence and nature of the microbial flora in bile of the patients with cholelithiasis and chronic cholecystitis as well as their antibiotic sensitivity pattern. which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Dear Editor, The most prevalent complication of cholelithiasis is chronic cholecystitis usually necessitating cholecystec-tomy (1). The biliary tract is usually sterile; however, if cholelithiasis is pigmented and cholestering, different microbes might be identified in and/or cultured from the bile or gallbladder wall (2). Microscopic examinations indicated that 20-50% of the patients with chronic cholecystitis have positive bile culture (3). Different reasons for biliary tract infection have been presented, e.g. ascending infection due to reflux of duodenal contents, blood-borne infection and infection spread through the portal-venues channels. Ascending infection from the duodenum is thought to be the primary mechanism by which bacteria enter the bile (4). Different microbes in the bile may be cause to post-cholecystectomy infections. Thus, understanding the most common organisms causing them and their antibacterial susceptibility pattern would be useful in prevention of these infections. The present study was carried out to achieve this aim. In this cross sectional study, 132 patients with cho-lelithiasis and chronic cholecystitis without risk factors for postoperative sepsis were subjected to elective laparoscopic cholecystectomy from September 2009 to September 2010. We ordered antibiotic prophylaxy routinely with 1gr keflin one house before operation. Using a questionnaire, patients' age, sex, clinical features of the patients, the isolated bacteria, and antibiogeram were recorded. During surgery 5-10 ml of the bile samples were aspirated with sterile syringe from gallbladder immediately after cholecystectomy; 3-5 ml was placed in a sterile container; another 3-5 ml was inoculated directly into an aerobic and anaerobic BacT/Alert blood culture bottle. The Samples were sent immediately to the Laboratory and incubated at 37°C for 24h. After the bacteria were isolated , we performed antibiotic sensitivity tests by the isolates carried out using Kirby-Bauer method with a colony in Mueller-Hinton agar medium (pH 7.2-7.4). The results were reported as susceptible, resistant and intermediate based on the diameter of the clear zone around disks with reference to the antibiotic standard table. The Data were analyzed by Chi-Square test and P<0.05 was considered significant. From the total 132 bile samples, bacteria were isolated in 50 samples (37.87%). Some other studies have shown that 20-50% of the patients …