Wound infection. Acute versus chronic cholecystitis

Area of Science:

• Surgical Infections
• Gastroenterology
• Microbiology

Background:

• Cholecystectomy is a common surgical procedure.
• Wound infections are a potential complication following cholecystectomy.
• Distinguishing the sources of wound infections is crucial for effective treatment.

Purpose of the Study:

• To retrospectively analyze wound infection rates and bacteriology after cholecystectomy.
• To compare wound infection characteristics between patients with acute and chronic cholecystitis.
• To identify the origins of wound infections to guide antibiotic therapy.

Main Methods:

• Retrospective analysis of 239 patients undergoing cholecystectomy.
• Comparison of wound infection incidence and causative organisms based on cholecystitis type (acute vs. chronic).
• Correlation of wound infections with bile culture results.

Main Results:

• Wound infection rates were higher in acute cholecystitis (17%) than chronic cholecystitis (8.9%).
• Staphylococcus aureus predominated in chronic cholecystitis wound infections, while gram-negative rods were more common in acute cases.
• Positive bile cultures were associated with a higher incidence of wound infections, with S. epidermidis, S. aureus, and Klebsiella sp. being common culprits.

Conclusions:

• Wound infections in chronic cholecystitis cases likely originate from external sources, not contaminated bile.
• Infections in acute cholecystitis may be linked to intra-abdominal sources or contaminated bile.
• Antibiotic strategies should be tailored based on the suspected source of infection in cholecystectomy patients.