The Clinical Investigation Of Bactoriological Characteristics Of Bile In Obstructive Jaundice

Objective:To observe the bacterial occurrence rate and its spectrum in bile during surgical treatment for obstructive jaundice.Methods:We selected 48 patients with significant jaundice due to obstructive disorders of biliary tract, remove fever and leucocyte increased patients,34 cases of males,14 cases of females, who were operated in the department of general surgery in Qilu Hospital from October 2010 to March 2011.All the cases were confirmed by CT. The method for bile sample collecting:we extracted 5ml bile before radiography when patients receiving ERCP or PTCD, for those without special treatment we collected 5ml bile during operation.Each bile sample that collected from the patients was cultured for detection of bacterial occurrence and screening antibiotic sensitivities.Results:Thirty-three patients were found bacterial positive in their bile (68.75%) The bacteria detecting rate in the benign obstruction patients was 42.10%, and that in the malignant obstruction patients was 86.20%, the difference between the two groups had statistical significance(P< 0.01). The bacteria detecting rate was 40.00% for the patients with low level of serum bilirubin (20.2-171μmol/L), it was 80.76% for the patients with median level of serum bilirubin (172-342.1μmol/L), and 85.71% for the patients with high level of serum bilirubin(^342.1μmol/L),which had statistical significant difference (P< 0.05).Bacterial spectrum and Antimicrobial susceptibility testing show that a total of 38 bacterial strains were isolated, which included 26 G- strains (68.4%), the arrangement of sensitive antibiotics were Imipenem, Meropenem, Amikacin, Cefoperazone Sulbactam, Gentamicin, Cefepime, Ceftazidime, Cotrimoxazole, Levofloxacin, Lefazolin, Piperacillin.12 G+ strains(31.6%), the arrangement of sensitive antibiotics were Teicoplanin,Linezolid,Vancomycin,Nitrofurantoin, Gentamicin,Penicillin,Levofloxaci-n and Ciprofloxacin.Conclusions:1,Bacteria detecting rate is different in different types of obst ructive jaundice, we need to give more attention to the patient with malignant tumor or high level of serum bilirubin for using proper antibiotics during surgical treatment.2,G- bacilli remain the predominant pathogens in biliary tract infections, the common pathogens are resistant to many antibiotics.