A study to assess the bactibilia among patients with obstructive jaundice in tertiary care centre

Abstract

Aim
The present study intended to analyze and asses the bacterial growth in bile culture among patients with obstructive jaundice in tertiary health care hospital and to know its antibiotic sensitivity.
Materials and Methods
A retrospective study on a total of 30 patients with a case of obstructive jaundice. Bile samples collected from patients were cultured by standard microbiological methods and sensitivity to common antibiotics assessed as per national committee for clinical laboratory standards [NCCLS] guidelines .The bacterial growth in bile culture and its bacterial sensitivity were analyzed.
Results
Of the total 30 patients presenting to hospital and included in study retrospectively, 16 were male and 14 were female. Bacteria were isolated in 21 of 30 bile sample (B+) while 9/30 patients were bile culture negative (B-). Bactibilia is found more often in benign causes of obstructive jaundice than in malignant condition. Gram negative bacilli were isolated in 17samples (81%) [E.coli 7(33%), Pseudomonas 1 (5%), k.pneumoniae 1(23%), Proteus 1(5%), Citrobacter 1(5%), Acinetobacter (5%), Providencia stuartii 1 (5%) ]. And Gram positive cocci isolated in 4 samples (19%) [Enterococcus 3 (14%), streptococcus 1 (5%)]. Gram negative bacilli were sensitive to Amikacin, Pipercaillin-tazobactam, Carbapenems like imipenem, ertapenem etc. but show resistance to third generation cephalosporins like ceftazidime, ceftizoxime, Cefotaxime and fourth generation cephalosporins like cefepime. Gram positive cocci were more sensitive to Amoxicillin, Vancomycin .
Conclusion
Bacteribilia is seen in 70%of bile samples. Gram negative bacteria like E.coli, k.pneumoniae, Pseudomonas, Proteus, Acinetobacter and Gram positive organism like Enterococcus and Streptococcus were commonly found in bile exudate. Gram negative bacteria showed resistance to third generation cephalosporins like ceftazidime, ceftizoxime, Cefotaxime and fourth generation cephalosporins like cefepime