Analysis of bile bacteria culture and antibiotic sensitivity after endoscopic nasobiliary drainage

Objective To identify the strain and frequency of microorganisms growth in bile which aspirated by endoscopic nasobiliary drainage(ENBD)and their antibiotic susceptibility,in order to guide anti-infective therapy.Methods This retrospective study included patients treated by encoscopic retrograde cholangio-pancreatography(ERCP)from January to April,2013.The results of the cultivation and antibiotic sensitive test of bile were analysed.Results 208 cases were included in the study,of which 180 cases have benign disease,while 28 cases have malignant disease.The bile culture was positive for bacterial growth in 112 cases(53.8%).The most frequently encountered organisms were Escherichia coli(46.8%),Enterococcus faecium(15.9%),Klebsiella pneumoniae(10.3%)and Proteus mirabilis(4.8%).Fourteen cases were co-infection.The positive rate of bile culture had no significant differences between patients with malignant or benign disease,patients with acute cholangitis or without acute cholangitis,patients who were treated by antibiotics before ERCP or not(58.9%vs.71.4%,51.7% vs 67.9%,54.5% vs.52.9%,P0.05).The positive rate of bile culture had significant differences between patients with or without biliary tract surgery(87.0% vs.49.7%,P0.01).Conclusions The biliary tract surgery(inculding ERCP and cholangioenterostomy)is one of the risk factors for microorganisms colonization in bile.The strain and frequency of microorganisms growth in bile culture and the antibiotic susceptibility would provide guidance to the selection of antibiotic for cholangitis.