Biliary bacteriology in cholelithiasis and relevant antibiotics application

Objective To explore the characteristics and drug sensitive of billiary bacteriology for the purpose of effective antibiotics application. Methods Culture and drug sensitive test of aerobic bacteria of bile specimens in 420 cases cholelithiasis which underwent surgical treatment from 2000 to 2001 in our hospital were done. Results 118 cases were positive in biliary bacterial culture with a positive rate of 28.1%. Among these cases 122 kinds of bacterial lines were found. Predominantly with Escherichia coli and Klebsiclla pneumonias, secondly with Serratia, Enterococcus and Staphylococcus aureus. For patients over 60 in age, positive rat was 48.2%, much higher than those age below 60. Positive rat of biliary bacteria in patients with common bile duct calculi was higher than patients with gallbladder stones. For acute cases positive rate was much higher than non-acute cases. Drug sensitive test showed that gram-positive bacteria were more sensitive to amoxycillin plus sulbactam, cefazollin, and amikacin, gram-negative bacteria were sensitive to amoxycillin plus sulbactam, third generation cephalosporins, quinolones, and amikacin. Conclusions The positive rate of biliary bacterial culture in cholelithiasis is related to biliary infective extent, bile stone position and age. The first choice of antibiotics application is amoxycillin plus sulbactam, or amikacin and metronidazole, the second choice is cefazollin or quinlones, and metronidazole.