The significance of anaerobic bacteria in biliary tract infection after hepatic portoenterostomy for biliary atresia.

Aspiration of the biliary atrium was performed in six children who developed cholangitis after hepatic portoenterostomy (Kasai procedure). All aspirates were cultured for aerobic and anaerobic bacteria. Aerobic bacteria were recovered in all six specimens and anaerobic organisms were recovered in three. The predominant aerobic organisms were Klebsiella pneumoniae (four isolates), enterococcus (three isolates, and Escherichia coli (two isolates). The anaerobes recovered were Bacteroides fragilis (two) and Clostridium perfringens (one). These findings demonstrate the recovery of anaerobic as well as aerobic organisms in cholangitis after hepatic portoenterostomy.