Prevalence of Bactibilia in Patients Undergoing Cholecystectomy for Gallbladder Diseases: An Observational Study

Bactibilia, the presence of bacteria in bile, is a significant concern in patients undergoing cholecystectomy for gallbladder diseases. It may contribute to post-operative complications, influencing surgical outcomes. Despite its clinical relevance, data on the prevalence, microbial spectrum, and antibiotic resistance patterns of bactibilia in the Indian population remain limited. This study aimed to assess the prevalence of bactibilia, identify the predominant bacterial isolates, and evaluate their antimicrobial susceptibility patterns.

This cross-sectional study was conducted in a tertiary care center in South India. Bile samples were collected intraoperatively from 121 patients undergoing interval cholecystectomy after at least six weeks of conservative management of acute cholecystitis. Microbiological analysis included both aerobic and anaerobic cultures, as well as antibiotic susceptibility testing. Postoperative outcomes, including surgical site infections (SSIs), were documented over a 30-day follow-up period.

Bactibilia was present in 57.9% of cases, with a higher prevalence in females (65.6%) and patients aged 51-60 years. The most common isolates were Escherichia coli (62.0%) and Acinetobacter baumannii (11.4%). Gram-negative bacteria exhibited high resistance to third-generation cephalosporins and fluoroquinolones but remained sensitive to amikacin and meropenem. Despite the presence of bactibilia, no postoperative SSI was observed, likely due to prophylactic antibiotic use.

A significant proportion of patients undergoing cholecystectomy had bactibilia, predominantly caused by E. coli and Acinetobacter. The study highlights emerging patterns of antimicrobial resistance, emphasizing the need for judicious antibiotic selection based on local antibiograms. Further research is warranted to refine antibiotic prophylaxis strategies in gallbladder surgery.