title: Bacterobilia in acute cholecystitis: Bile cultures' isolates, antibiotic sensitivities and antibiotic usage. A study on a Pakistani population.
abstract: Acute cholecystitis is one of the most common acute surgical conditions. Laparoscopic cholecystectomy remains the mainstay of treatment. In patients managed non-operatively, antibiotics play an important role in the treatment of cholecystitis. The current retrospective observational study was conducted at a tertiary care hospital in Karachi, and comprised medical records of patients admitted between 2008 and 2014with acute cholecystitis and in whom bile cultures were obtained. Of the 509 patients with a mean age of 51.15 ± 13.4years, early laparoscopic cholecystectomy (within 72hours) was performed on 473(92.9%) cases, while the rest underwent percutaneous cholecystostomy. Bile cultureswere positive in 171(33.6%) patients. Predominantly gram-negative organisms were isolated among a total of 137(27%), with E.coli 63(46%) being the most commonly isolated organism. Of the gram-positive organism, enterococcus 11(8%) was the most common. Antibiotic sensitivities were determined.Based on our findings gram-negative coverage alone should be sufficient in our segment of the population.
authors.affiliation: Section of General Surgery, Department of Surgery, The Aga Khan University, Karachi, Pakistan.
authors.forename: Yousaf Bashir
authors.initials: YB
authors.lastname: Hadi
authors.affiliation: Section of General Surgery, Department of Surgery, The Aga Khan University, Karachi, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Waqas
authors.affiliation: Section of General Surgery, Department of Surgery, The Aga Khan University, Karachi, Pakistan.
authors.forename: Hafiz Muhammad
authors.initials: HM
authors.lastname: Umer
authors.affiliation: Section of General Surgery, Department of Surgery, The Aga Khan University, Karachi, Pakistan.
authors.forename: Ammar
authors.initials: A
authors.lastname: Alam
authors.affiliation: Section of General Surgery, Department of Surgery, The Aga Khan University, Karachi, Pakistan.
authors.forename: Abdul Rehman
authors.initials: AR
authors.lastname: Alvi
authors.affiliation: Section of General Surgery, Department of Surgery, The Aga Khan University, Karachi, Pakistan.
authors.forename: Muhammad Rizwan
authors.initials: MR
authors.lastname: Khan
authors.affiliation: Section of General Surgery, Department of Surgery, The Aga Khan University, Karachi, Pakistan.
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D001646:Bile / Q000382:microbiology*; D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000382:microbiology* / Q000601:surgery; D002767:Cholecystostomy; D006801:Humans; D008875:Middle Aged; D010154:Pakistan; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acute cholecystitis, Bile cultures, Bacteriobilia, Antibiotic susceptibility.