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©The Author(s) 2022.
World J Gastrointest Surg. Dec 27, 2022; 14(12): 1340-1349
Published online Dec 27, 2022. doi: 10.4240/wjgs.v14.i12.1340
Published online Dec 27, 2022. doi: 10.4240/wjgs.v14.i12.1340
Table 1 Baseline characteristics of the bile culture-positive group and culture-negative group
| Parameter | Total | Culture-negative | Culture-positive | P value |
| Number | 185 | 147 | 38 | - |
| Age (yr; mean ± SD) | 54.3 ± 15.0 | 52.4 ± 14.7 | 61.3 ± 14.2 | 0.001 |
| BMI (kg/m2; mean ± SD) | 23.1 ± 3.4 | 23.4 ± 3.2 | 22.1 ± 3.8 | 0.040 |
| Male (%) | 80 (43.2) | 61 (33.0) | 19 (10.3) | 0.346 |
| Combined with CBDS (%) | 22 (11.9) | 5 (2.7) | 17 (9.2) | < 0.001 |
| Right upper abdominal pain (%) | 155 (83.8) | 120 (64.9) | 35 (18.9) | 0.118 |
| Positive Murphy sign (%) | 27 (14.6) | 24 (13.0) | 3 (1.6) | 0.189 |
| Diabetes mellitus (%) | 11 (5.9) | 8 (4.3) | 3 (1.6) | 0.699 |
| Hypertension (%) | 41 (22.2) | 32 (17.3) | 9 (4.9) | 0.800 |
| History of ERCP (%) | 7 (3.7) | 1 (0.5) | 6 (3.2) | < 0.001 |
| Previous intake of antibiotics (%) | 44 (23.8) | 29 (15.7) | 15 (8.1) | 0.011 |
| WBC count (> 10 × 109/L) | 16 (8.6) | 11 (5.9) | 5 (2.7) | 0.267 |
| Multiple stones (%) | 132 (71.3) | 99 (53.5) | 33 (17.8) | 0.018 |
| Max diameter of stone (cm; mean ± SD) | 1.2 ± 0.8 | 1.1 ± 0.8 | 1.3 ± 0.7 | 0.177 |
| Non-laparoscopic surgery (%) | 41 (22.2) | 19 (10.3) | 22 (11.9) | < 0.001 |
| Operative time (min), median (IQR) | 80 (59-120) | 70 (56.5-93.8) | 124 (95.0-188.8) | < 0.001 |
| Septic complications (%) | 10 (5.4) | 6 (3.2) | 4 (2.2) | 0.125 |
Table 2 Multivariate analysis results of risk factors for positive bile culture
| Variables | OR (95%CI) | P |
| Operation time > 80 min | 4.3 (1.4-13.1) | 0.01 |
| Combined with CBDS | 5.4 (1.3-21.9) | 0.02 |
Table 3 Composition of bile isolated bacteria
| Isolated microbes | Total strains | Frequency |
| Gram-negative | 28 | 73.7% |
| Escherichia coli | 19 | 50.0% |
| Klebsiella pneumoniae | 5 | 13.2% |
| Enterobacter cloacae | 2 | 5.3% |
| Enterobacter aerogenes | 1 | 2.6% |
| Enterobacter mirabilis | 1 | 2.6% |
| Gram-positive | 10 | 26.3% |
| Enterococcus faecalis | 6 | 15.8% |
| Enterococcus faecium | 3 | 7.9% |
| Staphylococcus aureus | 1 | 2.6% |
| Fungus | 0 | 0 |
Table 4 Antibiotics susceptibility test results for Enterococcus spp
| Enterococcus faecalis (6) | Enterococcus faecium (3) | |||
| Antimicrobial agents | AST | Resistance (%) | AST | Resistance (%) |
| Gentamicin | 1S + 5I | 5 (83.3) | 3I | 3 (100) |
| Streptomycin | 1S + 4I + 1R | 5 (83.3) | 2I + 1R | 3 (100) |
| Ciprofloxacin | 3S + 3I | 3 (50) | 2S + 1R | 1 (33.3) |
| Levofloxacin | 5S + 1I | 1 (16.7) | 2S + 1R | 1 (33.3) |
| Vancomycin | 6S | 0 | 2S + 1I | 1 (33.3) |
| Teicoplanin | 6S | 0 | 3S | 0 |
| Ampicillin | 6S | 0 | 1S + 1I + 1R | 2 (66.7) |
| Penicillin | 6S | 0 | 1S + 2R | 2 (66.7) |
| Quinupristin-dalfopristin | 1S + 5R | 5 (83.3) | 2S + 1I | 1 (33.3) |
| Tetracycline | 3S + 3R | 3 (50) | 2S + 1R | 1 (33.3) |
| Rifampin | 1S + 1I + 4R | 5 (83.3) | 2S + 1R | 1 (33.3) |
| Erythromycin | 4I + 2R | 6 (100) | 1S + 2R | 2 (66.7) |
Table 5 Antibiotics susceptibility test results for Enterobacteriaceae
| Antimicrobial agents | Escherichia coli (n = 19) | Klebsiella pneumoniae (5) | Enterobacter cloacae (2) | Enterobacter aerogenes (1) | Enterobacter mirabilis (1) | ||
| AST | Resistance (%) | AST | Resistance (%) | AST | AST | AST | |
| Amikacin | 16S + 3R | 3 (15.8) | 5S | 0 | 2S | 1S | 1S |
| Gentamicin | 12S + 7R | 7 (36.8) | 4S + 1R | 1 (20) | 2S | 1S | 1S |
| Amoxicillin | 2S + 10R | - | 5R | 5 (100) | 1R | 1R | - |
| Amoxicillin/clavulanic acid | 11S + 3I + 5R | 8 (42.1) | 3S + 1I + 1R | 2 (40) | 1R | 1I | 1S |
| Ticarcillin | 4S + 15R | 15 (78.9) | 5R | 5 (100) | 2S | 1S | 1S |
| Ticarcillin/clavulanic acid | 4S + 8R | - | 3S + 1R | - | 1S + 1R | 1S | 1S |
| Piperacillin | 7S + 12R | 12 (63.2) | 1S + 3I + 1R | 4 (80) | 2S | 1S | 1S |
| Piperacillin/tazobactam | 16S + 3R | 3 (15.8) | 5S | 0 | 2S | 1S | 1S |
| Cefazolin-1st | 1S + 5R | - | 1R | - | - | - | 1R |
| Cefoxitin | 11S + 8R | 8 (42.1) | 3S + 2R | 2 (40) | 1R | 1R | 1R |
| Cefuroxime-2nd | 6S + 13R | 13 (68.4) | 2S + 3R | 3 (60) | 2S | 1R | 1S |
| Cefotaxime-3rd | 8S + 1I + 10R | 11 (57.9) | 4S + 1I | 1 (25) | 2S | 1S | 1S |
| Ceftazidime-3rd | 9S + 10R | 10 (52.6) | 4S + 1R | 1 (25) | 2S | 1S | 1R |
| Cefepime-4th | 10S + 1I + 8R | 9 (47.3) | 4S + 1R | 1 (25) | 2S | 1S | 1S |
| ESBLs ( + ) | 10 | 10 (52.6) | 1 | - | - | - | - |
| Ciprofloxacin | 11S + 8R | 8 (42.1) | 4S + 1R | 1 (20) | 2S | 1R | 1I |
| Imipenem | 18S + 1R | 1 (5.3) | 5S | 0 | 2S | 1S | 1R |
| Meropenem | 19S | 0 | 5S | 0 | 2S | 1S | 1S |
- Citation: Huang XM, Zhang ZJ, Zhang NR, Yu JD, Qian XJ, Zhuo XH, Huang JY, Pan WD, Wan YL. Microbial spectrum and drug resistance of pathogens cultured from gallbladder bile specimens of patients with cholelithiasis: A single-center retrospective study. World J Gastrointest Surg 2022; 14(12): 1340-1349
- URL: https://www.wjgnet.com/1948-9366/full/v14/i12/1340.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v14.i12.1340