Page 25 - World Journal of Laparoscopic Surgery

ORIGINAL ARTICLE
Bacterial Infection and Sensitivity Pattern of Cholecystitis

among Cholecystectomy Patients

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Sunil Kaval , Swati Tewari , Ekta Rani 3
Received on: 27 April 2022; Accepted on: 28 September 2022; Published on: 07 December 2022

AbstrAct
Aims and objectives: This retrospective type of study was done to know the bacterial cause of cholecystitis and to isolate different bacteria present
in bile of cholecystectomy patients. Antibiotic sensitivity was also done to know the antibiotic-resistance pattern among the organism isolated.
Materials and methods: In this study, 126 patients’ bile was sent to the Microbiology Department for culture and antibiotic-sensitivity testing
during the period of October 2017–November 2018. Cultures were placed in blood agar and MacConkey agar. Organisms were isolated on the
basis of growth characteristics and biochemical findings. Antibiotic sensitivity was done using the Kirby–Bauer disk-diffusion method.
Results: This study included 126 post-cholecystectomy patients, out of which the male-to-female ratio was 1:2.71. While the female was 92 (83%)
and the male was 34 (17%). In this study, we have included all the age-groups of patients, but most of the patients were middle-aged, that is,
between 41 and 60 years 78 (62%). In the microbiological analysis, only 68 (54%) samples were culture-positive. In our study, Escherichia coli
43 (63.2%) was isolated among maximum samples and the second most common was Klebsiella spp. 17 (25%).
Conclusion: Therefore, it is important to know about common bacteria causing gallbladder infection and their antibiotic-resistance pattern.
This study may be helpful in designing the antibiotic prophylaxis among these patients.
Keywords: Analysis, Antibiotic sensitivity, Bile, Cholecystectomy.
World Journal of Laparoscopic Surgery (2022): 10.5005/jp-journals-10033-1540

IntroductIon 1 Department of Surgery, Lala Lajpat Rai Memorial Medical College
Gallbladder stones are one of the most common surgical conditions (Affiliated with Chaudhary Charan Singh University), Meerut, Uttar
in North India, and out of all surgeries done for the gastrointestinal Pradesh, India
1
tract, cholecystectomy is the most common. Bile is normally sterile, 2,3 Department of Microbiology, National Capital Region Institute of
but may get infected in cholelithiasis. The incidence of bacterial Medical Sciences (Affiliated with Chaudhary Charan Singh University),
presence in bile varies from 10 to 70%. Chances of Bactibilia are Meerut, Uttar Pradesh, India
increasing in patients having obstruction and stasis of gallbladder
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due to gallstones. The gallstone diseases are more prevalent in Corresponding Author: Sunil Kaval, Department of Surgery, Lala Lajpat
Rai Memorial Medical College (Affiliated with Chaudhary Charan Singh
Western countries like United States, United Kingdom, and Australia, University), Meerut, Uttar Pradesh, India, +91 9927888997, e-mail:
and incidence ranges between 15 and 25%. In India, gallstones are drswatitewari@gmail.com
more common in the East and northern parts of India as compared
3,4
with the South and West regions. In 85–95% of cases, cholecystitis How to cite this article: Kaval S, Tewari S, Rani E. Bacterial Infection
is associated with cholelithiasis. 5 and Sensitivity Pattern of Cholecystitis among Cholecystectomy
Patients. World J Lap Surg 2022;15(3):211–214.
Among all the culture-positive samples of bile, the most
common bacteria isolated were Escherichia and Klebsiella. The Source of support: Nil
bacteriological profile of bile sampled from the gallbladder is Conflict of interest: None
more informative of the cause of cholecystitis because gallbladder Ethical statement: The authors are accountable for all aspects of the

is a closed sac, and direct sampling from the gallbladder is more work in ensuring that questions related to the accuracy or integrity of
relevant to know the causative organism. 6,7 any part of the work are appropriately investigated and resolved.
The study was done to know the most common bacteria
associated with cholecystitis and their sensitivity pattern among at 37°C for 24–48 hours. The bile was reported sterile if there
cholecystectomy patients. was no growth even after 48 hours of incubation. All growth
of cultures were identified on the basis of colony morphology,
MAterIAls And Methods microscopic examination, and appropriate biochemical reactions.
The retrospective type of study was done for one-year duration Antimicrobial-susceptibility testing was done by Kirby–Bauer
in tertiary care settings. In patients of open cholecystectomy, method according to Clinical and Laboratory Standard Institute
8,9
bile was collected in a sterile syringe, in the case of laparoscopic (CLSI) Guidelines.
cholecystectomy, bile was collected in a sterile container. The
syringe or container is sent to the Microbiology Department results
after proper labeling. In microbiology lab, bile samples were This study included a total of 126 patients among which male-
inoculated on blood agar and MacConkey agar, and incubated to-female ratio was 1:2.71. While female was 92 (83%) and male

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