Gil Fortuño M, Granel Villach L, Sabater Vidal S, Soria Martín R, Martínez Ramos D, Escrig Sos J, Moreno Muñoz R, Igual Adell R
María Gil Fortuño, Servicio de Microbiología y Parasitología. Hospital General Universitari de Castelló. Avenida de Benicàssim, sn. 12004, Castelló, Spain.
Rev Esp Quimioter. 2019 Oct;32(5):426-431. Epub 2019 Sep 18.
Cholecystitis is an important cause of hospital admission. In moderate or severe cholecystitis, the delay in treatment can lead to serious complications. Our objective is to analyze the microorganisms isolated in bile from cholecystectomized patients and their sensitivity pattern, to evaluate the empirical treatment in those cases in which the surgical removal of the gallbladder should be delayed.
Prospective descriptive study of biliary cultures of patients undergoing cholecystectomy from May 2013 to February 2015, in the Surgery Department of the Hospital General Universitari de Castelló.
We studied 196 patients, 83 women (42.3%) and 113 men (57.7%), with an average age of 61.5 years. The most used antibiotics as empiric treatment were piperacillin/tazobactam (77.8%) and amoxicillin/clavulanic (14.8%). In 46.4% of patients (91/196) bile cultures were positive. 165 microorganisms were isolated. The majority were Gram-negative bacilli (60.5%), mainly of the Enterobacterales order (91/54.5%), with Escherichia coli being the most frequent microorganism (24%) followed by Klebsiella spp. (12.5%). 3 E. coli with extended-spectrum beta-lactamase (ESBL) and 1 K. pneumoniae with ESBL were isolated. Microorganisms producing carbapenemase and methicillin-resistant Staphylococcus aureus were not isolated.
The bile microbiota, with a predominance of Enterobacterales is similar to that found in european studies..
胆囊炎是住院的重要原因。在中度或重度胆囊炎中，治疗延迟可导致严重并发症。我们的目的是分析胆囊切除患者胆汁中分离出的微生物及其药敏模式，以评估在应延迟胆囊手术切除的病例中的经验性治疗。
对2013年5月至2015年2月在卡斯特利翁大学综合医院外科接受胆囊切除术的患者的胆汁培养进行前瞻性描述性研究。
我们研究了196例患者，其中83例女性（42.3%）和113例男性（57.7%），平均年龄61.5岁。作为经验性治疗最常用的抗生素是哌拉西林/他唑巴坦（77.8%）和阿莫西林/克拉维酸（14.8%）。46.4%的患者（91/196）胆汁培养呈阳性。分离出165种微生物。大多数是革兰氏阴性杆菌（60.5%），主要是肠杆菌目（91/54.5%），其中大肠埃希菌是最常见的微生物（24%），其次是克雷伯菌属（12.5%）。分离出3株产超广谱β-内酰胺酶（ESBL）的大肠埃希菌和1株产ESBL的肺炎克雷伯菌。未分离出产碳青霉烯酶的微生物和耐甲氧西林金黄色葡萄球菌。
以肠杆菌目为主的胆汁微生物群与欧洲研究中发现的相似。
