title: Microbiologic Data in Acute Cholecystitis: Ten Years' Experience from Bile Cultures Obtained during Percutaneous Cholecystostomy.
abstract: BACKGROUND
  The aim of the study was to describe the microbiology and susceptibility patterns in acute cholecystitis by examining bile culture results from patients who underwent percutaneous cholecystostomy and examine concordance with empiric treatment.
  
  
  METHODS
  A total of 124 patients with acute cholecystitis underwent percutaneous cholecystostomy between 2003 and 2012 at Emek Medical Center, Israel. Data on bile and blood culture results, isolate susceptibility, and clinical outcomes were retrieved from patient files.
  
  
  RESULTS
  Bile cultures obtained from 116 patients were positive in 70 (60.3%) patients. Blood cultures obtained from 77 patients were positive in 23 (31.1%). Escherichia coli was the most common isolate in 28.6% of bile cultures and 43.5% of blood cultures. The concordance between empiric treatment coverage and culture isolate susceptibility was 67.6%. In most discordant cases, the isolates were Enterobacter spp. (40.9%) and Enterococcus spp. (31.8%). Overall, the in-hospital mortality rate was 7%: 2% in patients with concordant treatment compared with 14% in patients with discordant treatment (p = 0.09). Empiric antibiotic regimens were adequate in only two-thirds of patients.
  
  
  CONCLUSIONS
  There might be a trend for poorer outcome in patients treated with inadequate antibiotic agents, emphasizing the importance of tailoring antibiotic treatment.
authors.affiliation: 1 Infectious Disease Unit, Emek Medical Center , Afula, Israel .|2 Infectious Disease Unit, Baruch Padeh Medical Center , Poriya, Israel .|3 Faculty of Medicine in the Galilee, Bar Ilan University , Israel .
authors.forename: Orna
authors.initials: O
authors.lastname: Nitzan
authors.affiliation: 4 Department of Surgery A, Emek Medical Center , Afula, Israel .
authors.forename: Yuri
authors.initials: Y
authors.lastname: Brodsky
authors.affiliation: 1 Infectious Disease Unit, Emek Medical Center , Afula, Israel .
authors.forename: Hana
authors.initials: H
authors.lastname: Edelstein
authors.affiliation: 4 Department of Surgery A, Emek Medical Center , Afula, Israel .|5 Technion-Rappaport Faculty of Medicine , Haifa, Israel .
authors.forename: Dan
authors.initials: D
authors.lastname: Hershko
authors.affiliation: 5 Technion-Rappaport Faculty of Medicine , Haifa, Israel .|6 Department of Community Medicine and Epidemiology, Carmel Medical Center , Haifa, Israel .
authors.forename: Walid
authors.initials: W
authors.lastname: Saliba
authors.affiliation: 7 Clinical Microbiology Laboratory, Emek Medical Center , Afula, Israel .
authors.forename: Yoram
authors.initials: Y
authors.lastname: Keness
authors.affiliation: 3 Faculty of Medicine in the Galilee, Bar Ilan University , Israel .|8 Clinical Microbiology Laboratory, Baruch Padeh Medical Center , Poriya, Israel .
authors.forename: Avi
authors.initials: A
authors.lastname: Peretz
authors.affiliation: 1 Infectious Disease Unit, Emek Medical Center , Afula, Israel .|5 Technion-Rappaport Faculty of Medicine , Haifa, Israel .
authors.forename: Bibiana
authors.initials: B
authors.lastname: Chazan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001419:Bacteria / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D001646:Bile / Q000382:microbiology*; D041881:Cholecystitis, Acute / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D002767:Cholecystostomy; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotics; bile; cholecystitis; culture; percutaneous cholecystostomy