The Analysis Of Bile Germiculture Positive Rate And Associated Factors In Patients With Common Bile Duct Stones

Objective:To survey the bacterium distribution of bile in patients with common bile duct stones, and to explore the relationship between the positive rate of bile germiculture and some influence factors.Methods:Bile specimens collected from111patients with common bile duct stones during ERCP from January2007to February2014were cultured. The results and related factors were statistically analyzed.Results:Among111cases bile specimens,84patients(85strains) were positive in germiculture with a positive rate of75.7%. Seventy-two Gram-negative bacteria(84.7%), twelve Gram-positive bacteria(14.1%) and1fungus(1.2%) were included in85bacterial strains. The two most common pathogens were Escherichia(62.4%) and Klebsiella(14.1%). Patients with cholangitis had a higher positive rate(81.8%) of germiculture than who were common bile duct stones simply(61.8%)(P<0.05). Patients with multiple stones in common bile duct had a higher positive rate(86.8%) than who were single stone(65.5%)(P<0.05). Patients with bile duct diameter larger than 1.2cm had a higher positive rate(84.0%) than who were smaller than1.2cm(58.3%)(P<0.05). Patients with different gender, age, use of antibiotic, silty form of common bile duct stones, surgical history of biliary tract, history of ERCP, juxta-papillary duodenal diverticula, had no statistically significant differences in bile germiculture with a positive rate when compared with control groups. Logistic regression analysis showed that accompanied with cholangitis, multiple stones in common bile duct and bile duct diameter larger than1.2cm were the risk factors of positive rate of bile germiculture(P<0.05).Conclusions:The predominant pathogens in patients with CBDS are Escherichia and Klebsiella. Accompany with cholangitis, multiple stones and the diameter large than1.2cm of the common bile duct are the risk factors of positive bile germiculture. Whether use antibiotics or not before ERCP has no significant correlation to the positive rate of bile germiculture.