Cozma Matei-Alexandru, Găman Mihnea-Alexandru, Diaconu Camelia Cristina, Berger Arthur, Zerbib Frank, Mateescu Radu Bogdan
Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Gastroenterology and Hepatology, Colentina Clinical Hospital, 020125 Bucharest, Romania.
Antibiotics (Basel). 2025 Jul 4;14(7):679. doi: 10.3390/antibiotics14070679.
Significant differences in antibiotic resistance (AR) rates and multi-drug resistant (MDR) bacteria incidence exist in patients with acute cholangitis (AC) from different countries or regions. We aim to characterize and compare the microbial spectrum and AR patterns in patients with AC from two tertiary centers in Europe.
We conducted a prospective, observational, multicentric study including patients diagnosed with AC and a positive bile culture, admitted to the Colentina Clinical Hospital (CCH), Bucharest, Romania, and the Haut-Lévêque Hospital (HLH), Bordeaux, France, between April 2022 and October 2023.
We included a total of 144 patients from the CCH with 190 positive bile cultures (31 patients had up to five episodes of AC during the study period) and 241 identified microbial strains, and 62 patients from the HLH with 67 positive bile cultures (5 patients had two episodes of AC) and 194 identified microbial strains. The most frequently isolated bacteria were (30.70%) and spp. (27.80%) in the CCH group, and (15.46%) and (22/11.34%) in the HLH group. Furthermore, 51 (21.16%) of the strains identified in the CCH group and 15 (7.21%) in the HLH group were MDR, such as extended-spectrum beta-lactamase-producing or carbapenemase-producing . The resistance rates for common antibiotics were 13.69% in the CCH group vs. 8.76% in the HLH group for ceftriaxone, 9.54% vs. 2.06% for meropenem, 16.59% vs. 6.70% for piperacillin/tazobactam, and 25.31% vs. 7.73% for levofloxacin.
This comparative study shows significant differences between these countries in terms of the AR rates and MDR bacteria prevalence, highlighting the role of bile cultures as a safe and cost-effective method for guiding antibiotic treatment, thereby reducing the AR rates and complications.
不同国家或地区的急性胆管炎（AC）患者在抗生素耐药性（AR）率和多重耐药（MDR）菌发生率方面存在显著差异。我们旨在对欧洲两个三级中心的AC患者的微生物谱和AR模式进行特征描述和比较。
我们进行了一项前瞻性、观察性、多中心研究，纳入了2022年4月至2023年10月期间在罗马尼亚布加勒斯特的科伦蒂纳临床医院（CCH）和法国波尔多的奥勒维克医院（HLH）确诊为AC且胆汁培养呈阳性的患者。
我们纳入了CCH的144例患者，其胆汁培养阳性190次（31例患者在研究期间发生多达5次AC发作），共鉴定出241株微生物菌株；以及HLH的62例患者，其胆汁培养阳性67次（5例患者发生2次AC发作），共鉴定出194株微生物菌株。CCH组中最常分离出的细菌是（30.70%）和 spp.（27.80%），HLH组中是（15.46%）和（22/11.34%）。此外，CCH组鉴定出的菌株中有51株（21.16%）为MDR，HLH组中有15株（7.21%）为MDR，如产超广谱β-内酰胺酶的 或产碳青霉烯酶的 。常用抗生素的耐药率在CCH组中头孢曲松为13.69%，HLH组为8.76%；美罗培南在CCH组为9.54%，HLH组为2.06%；哌拉西林/他唑巴坦在CCH组为16.59%，HLH组为6.70%；左氧氟沙星在CCH组为25.31%，HLH组为7.73%。
这项比较研究表明，这些国家在AR率和MDR菌患病率方面存在显著差异，突出了胆汁培养作为指导抗生素治疗的一种安全且经济有效的方法的作用，从而降低AR率和并发症。
