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Related Experiment Videos

Bile cultures and sensitivity patterns in malignant obstructive jaundice.

Rakesh Neve1, Sanjay Biswas, Vinay Dhir

  • 1Gastrointestinal Services, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai 400 012.

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
|March 6, 2003
PubMed
Summary

Bactibilia, or bacteria in bile, is common in malignant obstructive jaundice, affecting over 26% of patients. Identifying these bacteria and their antibiotic resistance is crucial for preventing postoperative complications.

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Surgical Oncology

Background:

  • Bactibilia is a significant risk factor for postoperative septic complications.
  • Malignant obstructive jaundice creates a favorable environment for bacterial growth in the biliary tract.

Purpose of the Study:

  • To identify bacterial organisms in the bile of patients with malignant obstructive jaundice.
  • To determine the antibiotic susceptibility patterns of these organisms.
  • To assess the incidence of postoperative septic complications.

Main Methods:

  • Retrospective analysis of 88 bile samples from 65 patients with malignant obstructive jaundice.
  • Bile collection via endoscopic retrograde cholangiography (ERC), biliary stent flushing, intra-operative sampling, and percutaneous transhepatic biliary drainage (PTBD).

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  • Analysis of bacterial spectrum, antibiotic sensitivity, and assessment of complications like cholangitis and wound infection.

    • Main Results:

    • Bactibilia was present in 26.1% of patients at initial ERC, with additional cases identified through other methods.
    • Commonly identified organisms included Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, and Proteus vulgaris.
    • Effective antibiotics against common pathogens included amikacin, gentamicin, cefotaxime, ceftazidime, and cefoperazone-sulbactam.

    Conclusions:

    • A significant proportion of patients with malignant obstructive jaundice harbor bacteria in their bile.
    • Post-ERC cholangitis is a frequent complication, particularly in patients with hilar biliary obstruction.