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Streptococcal bacteremia in hepatobiliary operations
Abstract:
The incidence of fecal streptococci in bile is between 5 and 15 per cent of all positive culture findings. Fecal streptococci are not susceptible to the aminoglycoside or cephalosporin antibiotics, although these drugs are widely favored for prophylaxis during surgical treatment of the biliary tract. Over a three year period, 64 episodes of bacteremia have been identified in patients undergoing treatment for obstructive jaundice. Fifteen (23 per cent) of these episodes were due to fecal streptococci. The implications of this finding are discussed and the role of acylureidopenicillin antibiotics for prophylaxis considered.
Insights
Fecal streptococci are common in bile infections and resistant to standard prophylactic antibiotics. This study highlights their significant role in bacteremia among patients with obstructive jaundice.
Area of Science:
- Microbiology
- Infectious Diseases
- Surgical Infections
Background:
- Fecal streptococci are frequently isolated from bile cultures.
- Aminoglycoside and cephalosporin antibiotics are commonly used for biliary tract surgical prophylaxis.
- These antibiotics exhibit limited efficacy against fecal streptococci.
Purpose of the Study:
- To investigate the incidence and clinical significance of fecal streptococci in biliary tract infections.
- To evaluate the role of fecal streptococci in bacteremia associated with obstructive jaundice.
- To consider alternative prophylactic antibiotic strategies.
Main Methods:
- Retrospective analysis of positive bile cultures over a defined period.
- Identification and susceptibility testing of isolated microorganisms.
- Review of patient records for episodes of bacteremia and clinical outcomes.
Main Results:
- Fecal streptococci accounted for 5-15% of all positive bile cultures.
- Fifteen out of 64 (23%) bacteremia episodes in obstructive jaundice patients were caused by fecal streptococci.
- Observed resistance of fecal streptococci to commonly used prophylactic antibiotics.
Conclusions:
- Fecal streptococci represent a significant pathogen in biliary tract infections, particularly in obstructive jaundice.
- Current prophylactic antibiotic regimens may be inadequate due to resistance patterns.
- Acylureidopenicillin antibiotics warrant consideration for prophylaxis in at-risk patient populations.