Analysis of Etiology and Drug Resistance of Biliary Infections

Summary: The bile was collected from fro patients with biliary infections, with the bacterium isolated to study the sensitivity of each kind of the bacterium to several antibiotics in common use. Except G-bacterium, we also found some kinds of G+ bacterium in infection bile. G-bacterium were not sensitive to Clindamycin, G+ bacterium were sensitive to Ciprofloxacin. Escherichia coli, Xanthomonas maltophilia, Enterobacter cloacae, Pseudomonas aeruginosa were sensitive to Ampicillin. G+ bacterium were not sensitive to Azactam. Enterococcus faecalis, Enterococcus faecium, Enterobacter cloacae were not sensitive to Ceftazidime. Enterococcus faecalis, Staphylococcus coagulase negative, Staphylococcus epidermidis, Pseudomonas aeruginosa were not sensitive to Ceftriaxone Sodium. We didn't found any bacterium resistance Imipenem. The possibility of the existence of G+ bacterium as well as drug resistance should be considered n patients with biliary infections. The value of susceptibility test should be respected to avoid drug abuse of antibiotics.

First case of biliary Aureimonas altamirensis infection in a patient with colon cancer in China

Aureimonas altamirensis,first reported in 2006,is an aerobic,gram-negative bacillus.It is usually considered a contaminant from the surrounding environment;however,recent evidences suggest that it may be an opportunistic pathogen in humans,which may cause multiple-site infections.Here,we report the first case of biliary A.altamirensis infection in a patient with colon cancer in Guangzhou,China.The A.altamirensis strain GZ8HT01 was isolated from the bile culture taken from the patient and identified by 16S ribosomal RNA gene sequencing.Additionally,the bacterial strain was sensitive to all antibiotics tested.The patient was effectively treated with imipenem-cilastatin.These findings are valuable for the early diagnosis and effective treatment of this emerging pathogen.

Microbiology of gallbladder bile in uncomplicated symptomatic cholelithiasis

BACKGROUND:Few studies have assessed microflora and their antibiotic sensitivity in normal bile and lithogenic bile with different types of gallstones. METHODS:We performed a case control study of 70 bile samples(35 cholesterol and 35 pigment stones from 51 females and 19 males,aged 21-72 years with a median age of 37 years)from patients who underwent laparoscopic cholecystectomy for uncomplicated cholelithiasis,and 20 controls(14 females and 6 males,aged 33-70 years with a median age of 38 years)who underwent laparotomy and had no gallbladder stone shown by ultrasound scan.The bile samples were aerobically cultured to assess microflora and their antibiotic susceptibility.The procedures were undertaken under sterile conditions. RESULTS:Thirty-eight(54%)of the 70 patients with gallstones had bacterial isolates.Nine isolates(26%)were from cholesterol stone-containing bile and 29 isolates (82%)from pigment stone-containing bile(P=0.01,t test). Twenty-eight of these 38(74%)bile samples were shown positive only after enrichment in brain heart infusion medium(BHI)(P=0.02,t test).The overall bacterial isolates from bile samples revealed E.coli predominantly,followed by P.aeruginosa,Enterococcus spp.,Klebsiella spp.and S. epidermidis.There were no bacterial isolates in the bile of controls after either direct inoculation or enrichment in BHI.CONCLUSIONS:Bacterial isolates were found in pigment stone-containing bile.Non-lithogenic bile revealed no bacteria,showing an association between gallstone formation and the presence of bacteria in bile.Antibiotic sensitivity patterns of isolated organisms were similar irrespective of the type of stone.