Abstract
Background
Bacterial infection is common in acute cholecystitis (AC). To identify appropriate
empirical antibiotics, we investigated AC-associated microorganisms and their susceptibilities
to antibiotics. We also compared preoperative clinical findings of patients grouped
according to specific microorganisms.
Methods
Patients who underwent laparoscopic cholecystectomy for AC between 2018 and 2019 were
enrolled. Bile cultures and antibiotic susceptibility tests were performed, and clinical
findings of patients were noted.
Results
A total of 282 patients were enrolled (147 culture-positive and 135 culture-negative).
The most frequent microorganisms were Escherichia (n = 53, 32.7%), Enterococcus (n = 37, 22.8%), Klebsiella (n = 28, 17.3%), and Enterobacter (n = 18, 11.1%). For Gram-negative microorganisms, second-generation cephalosporin
(cefotetan: 96.2%) was more effective than third-generation cephalosporin (cefotaxime:
69.8%). Vancomycin and teicoplanin (83.8%) were the most effective antibiotics for
Enterococcus. Patients with Enterococcus had higher rates of CBD stones (51.4%, p = 0.001) and biliary drainage (81.1%, p = 0.002), as well as higher levels of liver enzymes, than patients with other microorganisms.
Patients with ESBL-producing bacteria had higher rates of CBD stones (36.0% vs. 6.8%,
p = 0.001) and biliary drainage (64.0% vs. 32.4%, p = 0.005) than those without.
Discussion
Preoperative clinical findings of AC are related to microorganisms in bile samples.
Periodic antibiotic susceptibility tests should be conducted to select appropriate
empirical antibiotics.
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Article info
Publication history
Published online: February 02, 2023
Accepted:
January 30,
2023
Received:
December 27,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.
