Pitt H A, Postier R G, Cameron J L
Arch Surg. 1982 Apr;117(4):445-9. doi: 10.1001/archsurg.1982.01380280037008.
Patients undergoing urgent and complex biliary operations were studied to determine (1) whether bactibilia is associated with postoperative complications amd (2) whether antibiotic therapy influences biliary bacteriology. Aerobic and anaerobic cultures were performed on hepatic bile obtained at surgery in 134 patients. Cultures were repeated four to seven days postoperatively in 111 patients who had indwelling biliary tubes. Positive operative bile cultures were associated with an increased incidence of wound infection and postoperative renal dysfunction. Postoperative bile cultures showed a significant increase in the number of patients having bactibilia, and a significant alteration in the types of organisms isolated. Anaerobes were cultured from 15% of operative and 23% of postoperative cultures. Antibiotic therapy did not sterilize bile, but merely altered biliary bacteriology. Furthermore, prolonged aminoglycoside therapy was associated with a high incidence of renal dysfunction, especially in elderly patients.
对接受紧急和复杂胆道手术的患者进行了研究，以确定：（1）胆汁细菌感染是否与术后并发症相关；（2）抗生素治疗是否会影响胆道细菌学。对134例患者手术时获取的肝胆汁进行了需氧和厌氧培养。对111例留置胆管的患者在术后4至7天重复进行培养。术中胆汁培养阳性与伤口感染和术后肾功能障碍的发生率增加相关。术后胆汁培养显示，胆汁细菌感染患者数量显著增加，分离出的微生物类型也有显著变化。厌氧菌在15%的术中培养物和23%的术后培养物中被培养出来。抗生素治疗并未使胆汁无菌，而只是改变了胆道细菌学。此外，长期使用氨基糖苷类药物治疗与肾功能障碍的高发生率相关，尤其是在老年患者中。
