Clinicomicrobiological analysis of patients with cholangitis.
Acute cholangitis is inflammation of biliary ductal system from infection with an associated biliary obstruction. This retrospective study was done to determine the factors responsible for cholangitis and the microbiological profile of the bile in patients with cholangitis. In the study involving 348 patients, 36.4% had associated malignancy. A total of 54% of the bile samples were positive for aerobic culture. Nearly 66-73% of the Escherichia coli and Klebsiella isolates were Extended spectrum beta lactamases (ESBL) producers. Two isolates of Candida spps were also obtained. Polymicrobial infection was seen in 31.5% of the culture positive cases. Ideal antibiotics in case of cholangitis would be those which are excreted in the bile such as third-generation cephalosporins, ureidopenicillins, carbapenems and fluoroquinolones to combat resistance and polymicrobial aetiology. Anti-fungal drugs may also be necessary if the patient is not responding to biliary decompression and antibacterial agents to prevent fungaemia.
Department of Microbiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
S M
SM
Shenoy
S
S
Shenoy
S
S
Gopal
B V
BV
Tantry
S
S
Baliga
A
A
Jain
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002175:Candida / Q000187:drug effects / Q000472:pathogenicity; D002511:Cephalosporins / Q000494:pharmacology; D002761:Cholangitis / Q000382:microbiology*; D004926:Escherichia coli / Q000187:drug effects / Q000472:pathogenicity; D005260:Female; D006801:Humans; D007709:Klebsiella / Q000187:drug effects / Q000472:pathogenicity; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000472:pathogenicity; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018440:beta-Lactam Resistance
D000900:Anti-Bacterial Agents; D002511:Cephalosporins