title: Microbial profile and antibiotic sensitivity pattern in acute bacterial cholangitis.
abstract: BACKGROUND
  The changing antimicrobial sensitivity pattern of causative organisms poses a therapeutic challenge in treating patients with acute cholangitis. We therefore evaluated the microbial profile and sensitivity pattern to antibiotics in patients with acute bacterial cholangitis.
  
  
  METHODS
  Data of patients above 18 years of age with acute bacterial cholangitis seen between January 2004 and March 2007 were retrospectively analyzed. The study was continued prospectively from April 2007 to December 2008. Data on clinical features, etiological and microbial profile and therapy, and patient outcomes were analyzed. In the prospective group, the antibiotic susceptibility patterns of organisms grown on bile and blood culture were also obtained.
  
  
  RESULTS
  One hundred and eighty-five patients with acute cholangitis were studied. Choledocholithiasis (62.7%) and malignancy (29.2%) were the main predisposing factors. Bile culture was positive in 88 of 95 patients, and blood culture was positive in 47 of 178 (26.4%) patients. Bile cultures were predominantly polymicrobial (69.5%) in contrast to blood cultures (2.2%). E. coli was the predominant isolate in blood and bile. No growth was seen on anaerobic bile or blood cultures. The prospective group showed high resistance of E. coli to third generation cephalosporins and ciprofloxacin.
  
  
  CONCLUSIONS
  Changing antimicrobial sensitivity patterns requires a revision of empiric antibiotic therapy policy in cholangitis.
authors: Department of Gastrointestinal Sciences, Christian Medical College, Vellore 632 004, India.
authors: Manoj Kumar
authors: MK
authors: Sahu
authors: Ashok
authors: A
authors: Chacko
authors: Amit Kumar
authors: AK
authors: Dutta
authors: John Antony Jude
authors: JA
authors: Prakash
mesh_terms: D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D002761:Cholangitis / Q000188:drug therapy / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents