Bacteriological Study of Bile in Cholelithiasis Patients Undergoing Cholecystectomy in Azar Hospital of Gorgan (2005-2006)

Bile duct obstruction due to gall stone is the most common cause of biliary infection. Bacteria stabilize during the inflammation of gallbladder and it is confirmed that longer duration of inflammation is associated with more risk of post operative infection. In this study we sought to determine the biliary microbial flora in patients with acute and chronic cholecystitis in order to find the suitable antibiotic to treat preoperative infection by using antibiotic susceptibility test (antibiogram). This was a descriptive cross sectional study. From all patients with acute and chronic cholecystitis due to stones that underwent cholecystectomy a sterile sample was taken during surgery and sent for laboratory analysis. It was examined for gram negative and gram positive, aerobic and anaerobic bacteria. Bile culture was performed within an hour after taking samples. The data were registered and analyzed by statistical SPSS software version 11.5. The majority of patients (73.1%) suffered from chronic cholecystitis and the stones obtained were 48.7% of cholestrolic type and 29.5% of mixed type. No significant relationship existed between stone type and bile culture results. Gram positive cocci (e.g. streptococcus) and gram negative bacili (e.g. citrobacterfrondei) were found in 11.5% and 17.9% of the patients, respectively. Most sensitivity to antibiotics was towards fluoroquinolones. Study results showed that bile fluid was not infected in most of the cases and in positive cases sensitivity to fluoroquinolones such as ciprofloxacin, ofloxacin and norfloxacin was detected. The relationship between stone type and culture results was not significant.