The microflora of bile in Ghanaians

Bile was obtained from the gall bladder of 104 patients undergoing cholecystectomy for gall stone disease. Bile was also obtained from the common bile duct and T-tube of 17 patients who also had exploration of common bile duct. During the same period, 148 cholecystectomies were performed. The specimens were sent for culture and sensitivity and 32.7% of the specimens grew bacteria. The factors that were associated with positive culture were emergency cholecystectomy for acute cholecystitis and empyema of gall bladder, carcinoma of gall bladder and obstructive jaundice. The commonest organisms were E. Coli (28.2%) and Klebsiella (17.9%). Pseudomonas surprisingly formed 10.2% of the cultured organisms. Salmonella that causes typhoid, which is an endemic disease in Ghana, formed only 7.7% of the isolates. Most of the organisms were resistant to Ampicillin and tetracyclines. The antibiotics that most were sensitive to were Gentamicin and Cefuroxime. Therefore the antibiotics that are recommended for use as prophylaxis in biliary tract surgery are Gentamicin or Cefuroxime.