Correlation between a positive gallbladder culture and subsequent wound infection after biliary surgery--a retrospective study of 840 patients.
The possible correlation between a positive culture of samples from the gallbladder wall and/or bile at the time of cholecystectomy and subsequent wound infections was retrospectively studied in a series of 840 patients. Positive cultures were present in 138 patients (16.4) and 19 different bacterial species could be identified. Cultured bile showed Escherichia coli in 36% of cases. The wound infection rate was 9% (72 patients) with Staphylococcus aureus cultured from the infected wounds in 64%. Fifty-eight of these 72 patients (80%) were at high risk. In contrast with the literature, no correlation existed between a positive bile culture and subsequent wound infection. In view of these results there is no need to evaluate a Gram-stain during surgery. Antimicrobial prophylaxis should be restricted to high-risk patients and the antibiotics used must be effective against exogenic wound contaminants.
D000328:Adult; D000368:Aged; D001420:Bacteria, Aerobic / Q000302:isolation & purification; D001421:Bacteria, Anaerobic / Q000302:isolation & purification; D001431:Bacteriological Techniques; D001646:Bile / Q000382:microbiology*; D002763:Cholecystectomy; D002764:Cholecystitis / Q000382:microbiology / Q000601:surgery*; D002769:Cholelithiasis / Q000382:microbiology / Q000601:surgery*; D005260:Female; D042882:Gallstones / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk; D013530:Surgical Wound Infection / Q000382:microbiology*