Bile Pathogen Detection And Antibiotic Drug Sensitive Test In Patients With Cholelithiasis

Objective To survey the biliary pathogen and their sensitivity to antibiotics in patients with cholelithiasis and to understand the positive rate of bacterial culture and the influence factors in patients with cholelithiasis.Methods Microbes automatic detection system was applied to detect the spectrum of bile pathogen and their drug sensitivities in 61 cholelithiasis patients who underwent endoscopic retrograde cholangiopancreatography(ERCP) during February to November in 2007.Results 42 specimen common cultures were positive in 61 specimen (68.8%),including 36 gram-negative strains(85.7%),5 gram-positive strains (11.9%)and 1 fungus(2.4%).The most common pathogenic bacteria were Escherichia coli(45.2%)and Klebsiella pneumoniae(26.2%).Patients with cholangitis had a higher rate(76.9%)of positive cultures of common duct bile than those without biliary tract infection(50.0%).Patients who had an operation on biliary tract before ERCP had a higher rate(94.1%).Age greater than 60 years had a significant influence on the rate of positive bile cultures(78.0%).The number of duct stones had no significant influence on the percentage of positive cultures.The result of drug sensitivity showed the resistant rates of gram-negative strains to Piperacillin/taz,Cefoperazone/sul,amikacin, meropenem and imipenem is less than 5%is high.In this study gram-negative strains were highly resistants to the piperacillin,ciprofloxacin and levofloxacin (＞70%).None of gram-positive strains was resistant to penicillin,vancomycin and teicoplanin,and the resistant rates of ciprofloxacin,levofloxacin and erythromycin is high(＞50%).Conclusions Among patients whit common bile duct stones,there was an increasing percentage of positive cultures according to the severity of the disease.Age and history of biliary tract surgery had important infuence,but the number of duct stones had no influence on positive rate of cultures.The main pathogen in patients with cholelithiasis was gram-negative,the drug resistant rates is rising.