Evaluation of Bile Microbiology and its Pattern of Resistance in Patients with Acute Cholecystitis

Acute cholecystitis needs to be treated due to its high prevalence and mortality rate worldwide and high consumption of antibiotics before and after surgery for this disease.

This study investigated the microbiology of bile samples and their antibiogram in patients with acute cholecystitis referred to the Imam Hossein Hospital, Tehran, Iran, in 2019 - 2020.

This cross-sectional study was performed on 97 patients with acute cholecystitis. A surgeon collected bile samples before cholecystectomy. Then, the samples were examined for culture and antibiogram. The results were analyzed using SPSS 16 statistical software.

Among the measured variables, only the relationship between the age category and culture result was statistically significant (P < 0.032). Also, the culture result was negative in 67% of the patients, and in the positive culture of the samples, organisms grown mainly were Escherichia coli, Pseudomonas, and Enterococcus. Among the organisms, 53.1% were susceptible, and in resistant cases, the most resistant mechanism was extended-spectrum beta-lactamase (ESBL). Moreover, the relationship between different organisms with the sex of patients (P < 0.032) and having gallstones (P < 0.011) was significant.

According to studies, 30 - 50% of cholecystitis cultures of bile samples were positive, the most common organisms growing in these cultures include Ecoli, Pseudomonas, Klebsiella pneumonia, and Enterococcus and Salmonella species. Also, the most common mechanisms of antibiotic resistance are ESBL, CRE, and AmpC types, respectively. More research needs to be carried out on the prevalence of microbes in cholecystitis and other diseases and the selection of appropriate antibiotic regimens and mechanisms of antibiotic resistance.