Published online Dec 27, 2022. doi: 10.4240/wjgs.v14.i12.1340
Peer-review started: August 28, 2022
First decision: September 12, 2022
Revised: September 26, 2022
Accepted: November 20, 2022
Article in press: November 20, 2022
Published online: December 27, 2022
Processing time: 120 Days and 17.7 Hours
Bacterial infection is an important cause of cholelithiasis or gallstones and interferes with its treatment.
Identified microbial spectrum and drug resistance of pathogens cultured from gallbladder bile specimens is helpful for targeted preventive and therapeutic drugs in the perioperative period.
Investigate the bile microbial spectrum of patients with cholelithiasis and the drug susceptibility patterns in order to establish an empirical antibiotic treatment for cholelithiasis-associated infection.
A retrospective single-center study was conducted on patients diagnosed with cholelithiasis between May 2013 and December 2018.
The presence of common bile duct stones (OR = 5.4, 95%CI: 1.3-21.9, P = 0.03) and longer operation time (> 80 min) (OR = 4.3, 95%CI: 1.4-13.1, P = 0.01) were identified as independent risk factors for positive bile culture. Gram-negative bacteria were detected in 28 positive bile specimens, and Escherichia coli (E. coli) (19/28) and Klebsiella pneumoniae (5/28) were the most frequently identified species. Gram-positive bacteria were present in 10 specimens. All the isolated E. coli strains were sensitive to carbapenems, with the exception of one imipenem-resistant strain. K. pneumoniae showed a similar resistance spectrum to E. coli. Enterococcus spp. was largely sensitive to glycopeptides and penicillin, except for a few strains of E. faecium.
The presence of common bile duct stones and longer operation time were identified as independent risk factors for positive bile culture in patients with cholelithiasis. The most commonly detected bacterium was E. coli. The combination of β-lactam antibiotics and β-lactamase inhibitors prescribed perioperatively appears to be effective against bile pathogens and is recommended.
To explore the characteristics of patients infected with drug-resistant bacteria and the prevention and treatment of drug-resistant bacteria.