title: Bile culture and susceptibility testing of malignant biliary obstruction via PTBD.
abstract: OBJECTIVE
  To assess the information obtained by bile culture and susceptibility testing for malignant biliary obstruction by a retrospective one-center study.
  
  
  METHODS
  A total of 694 patients with malignant biliary obstruction received percutaneous transhepatic biliary drainage during the period July 2003 to September 2010, and subsequently, bile specimens were collected during the procedure. Among the 694 patients, 485 were men and 209 were women, ranging in age from 38 to 78 years (mean age 62 years).
  
  
  RESULTS
  A total of 42.9% patients had a positive bile culture (298 of 694). Further, 57 species of microorganisms and 342 strains were identified; gram-positive bacteria accounted for 50.9% (174 of 342) and gram-negative bacteria accounted for 41.5% (142 of 342) of these strains. No anaerobes were obtained by culture during this study. The most common microorganisms were Enterococcus faecalis (41 of 342, 11.9%), Escherichia coli (34 of 342, 9.9%), Klebsiella pneumoniae (28 of 342, 8.2%), Staphylococcus epidermidis (19 of 342, 5.5%), Enterococcus (18 of 342, 5.3%), and Enterobacter cloacae (16 of 342, 4.7%). The percentage of β-lactamase-producing gram-positive bacteria was 27.6% (48 of 174), and the percentage of gram-negative bacteria was 19.7% (28 of 142). The percentage of enzyme-producing Escherichia coli was 61.7% (21 of 34).
  
  
  CONCLUSIONS
  The bile cultures in malignant biliary obstruction are different from those in the Tokyo Guidelines and other benign biliary obstruction researches, which indicates that a different antibacterial therapy should be applied. Thus, knowledge of the antimicrobial susceptibility data could aid in the better use of antibiotics for the empirical therapy of biliary infection combined with malignant biliary obstruction.
authors: Department of Interventional Therapy, Tinajin Medical University Cancer Institute and Hospital, Tianjin, People's Republic of China.
authors: Haipeng
authors: H
authors: Yu
authors: Zhi
authors: Z
authors: Guo
authors: Wenge
authors: W
authors: Xing
authors: Xiuying
authors: X
authors: Guo
authors: Fang
authors: F
authors: Liu
authors: Baoguo
authors: B
authors: Li
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D001646:Bile / Q000382:microbiology*; D001650:Bile Duct Neoplasms / Q000150:complications*; D016009:Chi-Square Distribution; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000382:microbiology* / Q000473:pathology*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy / Q000382:microbiology*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents