Claesson B E, Holmlund D E, Mätzsch T W
Surg Gynecol Obstet. 1986 Jun;162(6):531-5.
The microflora of the bile and wall of the gallbladder was prospectively investigated in 104 nonselected consecutive patients treated with early cholecystectomy for acute cholecystitis after an average hospital stay of 1.8 days. The chief purpose was to relate the findings of cultures to duration of the illness. Special attention was paid to anaerobic isolation techniques. The cultures yielded 107 strains, representing 36 species, with overall agreement between four different sampling procedures. Aerobic gram-negative rods predominated, followed by streptococci and anaerobes (48, 31 and 15 per cent, respectively). The incidence of positive culture results (always greater than or equal to 10(6) colon forming units per milliliter) was 81 per cent among the patients who underwent operation within two days from the onset of symptoms and 50 to 65 per cent after longer preoperative intervals. The shorter interval was significantly more often associated with growth solely of anaerobes (p = 0.03). Postoperative sepsis was caused by biliary bacteria and not related to preoperative duration of illness. Appropriate perioperative antibiotic coverage significantly reduced sepsis--3 versus 20 per cent (p = 0.05).
对104例因急性胆囊炎接受早期胆囊切除术的非选择性连续患者进行了前瞻性研究，这些患者平均住院1.8天后接受手术。主要目的是将培养结果与疾病持续时间相关联。特别关注厌氧分离技术。培养物产生了107株菌株，代表36个菌种，四种不同采样程序的结果总体一致。需氧革兰氏阴性杆菌占主导，其次是链球菌和厌氧菌（分别占48%、31%和15%）。症状出现后两天内接受手术的患者中，培养结果阳性（始终大于或等于每毫升10(6)个菌落形成单位）的发生率为81%，术前间隔较长的患者中该发生率为50%至65%。较短的间隔时间更常与仅厌氧菌生长相关（p = 0.03）。术后败血症由胆汁细菌引起，与术前疾病持续时间无关。适当的围手术期抗生素覆盖显著降低了败血症的发生率——从20%降至3%（p = 0.05）。
