Microbiological Profile and Antibiotic Sensitivity Pattern of Bile Culture in Patients Undergoing Laparoscopic...

Background Laparoscopic Cholecystectomy is, a frequently performed surgery for symptomatic cholelithiasis. On various studies, in a significant proportion of patients developing gallstones, biliary infection has been noted. Objective To assess the bacteriological profile of bile and to determine antibiotic sensitivity pattern for preoperative prophylaxis in laparoscopic cholecystectomy patients. Method A prospective observational study was carried out from November 2021 to April 2022 at the Department of Surgery, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal after obtaining ethical approval from the Institutional Review Committee of Nepalese Army Institute of Health Sciences (Reg. No: 478) and informed written consent from each patient. A total of 123 patients undergoing for laparoscopic cholecystectomy were studied. About 5 ml of bile aspirated from gall bladder was collected in a sterile syringe and transported to laboratory for culture and sensitivity. Demographic characteristics, culture outcomes and postoperative parameters were collected using predesigned Performa. Statistical analysis was performed using Statistical Package for the Social Sciences software (SPSS). Result Bile culture was positive in 25 (20.33%) patients. The most predominant organisms were Gram negative bacteria. The most commonly isolated organisms were Escherichia coli, Pseudomonas spp and Klebsiella spp. On sensitivity profile, the isolates were most sensitive to antibiotics like: amikacin, gentamicin, clindamycin, meropenem, imipenem, linezolid and piperacillin plus tazobactum with resistance encountered against ampicillin. Conclusion Most common organisms isolated from bile culture were Gram negative. Aminoglycoside group of drugs was found to be most sensitive and can be used as first line drug for preoperative prophylaxis in patients undergoing laparoscopic cholecystectomy. It also highlights on the importance of understanding demographical and clinical aspects of patient's profile along with bactibilia.