title: Extended Spectrum-β-Lactamase or Carbapenemase Producing Bacteria Isolated from Patients with Acute Cholangitis.
abstract: OBJECTIVE
  This study assessed the antibiotic resistance organisms isolated from the blood and bile of acute cholangitis and evaluated risk factors associated with them and their impact on clinical outcomes.
  
  
  METHODS
  The identities and antibiotic resistance profiles of bacteria isolated from 433 cases of acute cholangitis from 346 patients were analyzed. Risk factors and the outcomes of patients infected with them were assessed.
  
  
  RESULTS
  Microorganisms were isolated from 266 of 419 blood cultures and 256 of 260 bile cultures. Isolates from bile and blood were identical in 71% of the cases. A total of 20 extended spectrum-β-lactamase (ESBL)-producers and 4 carbapenemase-producing organisms were isolated from blood, and 34 ESBL-producers and 13 carbapenemase-producers were isolated from bile. Sixty-four (14.8%) cases were infected with any one of these bacteria isolated from blood or bile. Risk factors associated with them in blood were nosocomial infection and prior biliary intervention. In bile, indwelling biliary device was a risk factor associated with them. Antibiotic-resistant bacteria were associated with mortality, independent of other prognostic factors.
  
  
  CONCLUSIONS
  ESBL or carbapenemase-producing bacteria were frequently isolated in acute cholangitis patients especially with prior biliary intervention and nosocomial infection. Isolation of antibiotic-resistant bacteria was an independent risk factor of mortality.
authors.affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Ja Chung
authors.initials: JC
authors.lastname: Goo
authors.forename: Mun Hyuk
authors.initials: MH
authors.lastname: Seong
authors.forename: Young Kwang
authors.initials: YK
authors.lastname: Shim
authors.forename: Hee Seung
authors.initials: HS
authors.lastname: Lee
authors.forename: Joung-Ho
authors.initials: JH
authors.lastname: Han
authors.forename: Jung-Ho
authors.initials: JH
authors.lastname: Han
authors.forename: Kyeong Seob
authors.initials: KS
authors.lastname: Shin
authors.forename: Jae-Woon
authors.initials: JW
authors.lastname: Choi
authors.forename: Sei Jin
authors.initials: SJ
authors.lastname: Youn
authors.forename: Seon Mee
authors.initials: SM
authors.lastname: Park