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Biliary sepsis: an ascending infection

R D Bapat1, A N Supe, A Patwardhan

  • 1Department of Gastroenterology Surgery, Seth G S Medical College, Mumbai.

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
|October 1, 1996
PubMed
Summary
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Bactobilia, or bacteria in the bile, is common in patients with biliary disease, especially obstructive jaundice. Ascending infection is the primary cause, and prophylactic antibiotics show reduced efficacy in obstructed bile ducts.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Surgical Infections

Background:

  • Biliary tract infections are a significant clinical concern.
  • Understanding the source and bacteriology of biliary sepsis is crucial for effective treatment.

Purpose of the Study:

  • To investigate the bacteriology of normal and obstructed biliary tracts.
  • To identify the primary mode of biliary infection.

Main Methods:

  • Bile samples from 57 patients undergoing biliary surgery were cultured for aerobic and anaerobic bacteria.
  • Urine, nasal, and throat swabs were also cultured to identify endogenous infection sources.
  • Antibiotic concentrations in bile were measured after preoperative antibiotic administration.

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Main Results:

  • Bactobilia was present in 66.7% of patients, with higher prevalence in obstructive jaundice (83.3%).
  • Escherichia coli was the most common isolate; ascending infection from the duodenum was frequently observed.
  • Antibiotic concentrations in the obstructed biliary tree were significantly lower than in the non-obstructed system.

Conclusions:

  • Ascending infection is the predominant route for biliary sepsis.
  • Prophylactic antibiotics achieve suboptimal concentrations in obstructed biliary tracts, potentially impacting treatment efficacy.