Gastroenterologia y hepatologia · 2025
Clinical and microbiological profile in obstructive biliary disease in a tertiary center: Observational study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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González-Villarreal Marusia, Jáquez-Quintana Joel Omar, Bocanegra-Ibarias Paola, Millán-Alanís Juan Manuel, Reyna-Aréchiga Ariadnee Irma, Cab-Morales Víctor Andrés, Hernández-Rodarte Valeria, Camacho-Ortiz Adrián, Maldonado-Garza Héctor Jesús
Аннотация
AIMS: There is limited information on bacterial isolation, antibiotic susceptibility, and microbiological profile in obstructive biliary disease (OBD). Providing information on this could help offer more effective empirical antibiotic therapy in clinical cholangitis. This study aims to evaluate the clinical and microbiological profile in obstructive biliary disease.
PATIENTS AND METHODS: The study was conducted at a tertiary academic center between August 2021 and January 2023. Hospitalized patients with OBD, with indication for biliary drainage by endoscopic retrograde cholangiopancreatography, were recruited. Biliary samples were obtained following a standardized protocol, and were processed in laboratory for Gram staining, culture, subculture. Microorganisms were identified and subjected to antibiotic susceptibility testing.
RESULTS: A total of 61 patients were included, 73.8% were women, average age was 44.8 years. Overweight/obesity was the most common comorbidity (62.3%); clinical cholangitis was present in 75.4%. Biliary lithiasis was the most common etiology of OBD (86.9%). Positive cultures were obtained in 44.3% of participants, predominating the group of Gram-positive bacteria; individually, Escherichia coli was the most isolated microorganism. A 68.2% of bacteria showed resistance to at least one antibiotic. We found significant associations between bile appearance and cholangitis, bile appearance and OBD etiology, OBD etiology and cholangitis severity. Male sex, increased age, tobacco use were associated with positive cultures. We found a spectrum of microorganisms and antibiotic susceptibilities partially different from those of Tokyo Guidelines 2018 and other publications.
CONCLUSIONS: Our findings highlight the need to characterize microbiological profile in OBD according to each region.
PATIENTS AND METHODS: The study was conducted at a tertiary academic center between August 2021 and January 2023. Hospitalized patients with OBD, with indication for biliary drainage by endoscopic retrograde cholangiopancreatography, were recruited. Biliary samples were obtained following a standardized protocol, and were processed in laboratory for Gram staining, culture, subculture. Microorganisms were identified and subjected to antibiotic susceptibility testing.
RESULTS: A total of 61 patients were included, 73.8% were women, average age was 44.8 years. Overweight/obesity was the most common comorbidity (62.3%); clinical cholangitis was present in 75.4%. Biliary lithiasis was the most common etiology of OBD (86.9%). Positive cultures were obtained in 44.3% of participants, predominating the group of Gram-positive bacteria; individually, Escherichia coli was the most isolated microorganism. A 68.2% of bacteria showed resistance to at least one antibiotic. We found significant associations between bile appearance and cholangitis, bile appearance and OBD etiology, OBD etiology and cholangitis severity. Male sex, increased age, tobacco use were associated with positive cultures. We found a spectrum of microorganisms and antibiotic susceptibilities partially different from those of Tokyo Guidelines 2018 and other publications.
CONCLUSIONS: Our findings highlight the need to characterize microbiological profile in OBD according to each region.