Aerobic bacteria associated with symptomatic gallstone disease and their antimicrobial susceptibility

Introduction: Gallstone disease is a major health problem throughout the world. Apart from surgery prompt administration of appropriate antibiotics to control the biliary tract infection is important.
Objective: Illustrate the bacteriology of gallstone disease.
Design: The bile stones and bile of patients with symptomatic gallbladder disease, who underwent cholecystectomy, over a period of one year, were cultured aerobically in blood agar and MacConkey agar. Enrichment was not done, as it was not indicated in previous studies. The isolates were identified according to standard microbiological procedures and were tested for their sensitivity pattern.
Settings: Department of Microbiology, University of Sri Jayawardenapura and Colombo South Teaching Hospital, Kalubowila, Sri Lanka.
Results: Twenty percent of the patients were positive for bacteria in either bile or stones. Escherichia coli (40%), Klebsiella spp (35%) and Enterobacter spp (20%) were the commonest isolates. Ninety one percent of all isolates were Coliforms.
Conclusions: We recommend obtaining of cultures of bile and gallstones at the time of cholecystectomy so that appropriate antibiotics can be administered in the event of a positive culture to prevent serious complications like gram negative septicaemia. According to our results, co-amoxiclav in combination with an aminoglycoside for aerobic bacteria along with metronidazole to cover anaerobic bacteria is an empirical therapy that can be used before the results of bacteriological cultures. Cefotaxime or imipenem can be used for aerobic bacteria as an alternative treatment.  

doi: 10.4038/gmj.v11i1.1110

Galle Medical Journal Vol.11(1) 2006 9-13