Darko R, Archampong E Q
Department of Surgery, University of Ghana Medical School.
West Afr J Med. 1994 Apr-Jun;13(2):113-5.
Bile was obtained from the gall bladder of 104 patients undergoing cholecystectomy for gall stone disease. Bile was also obtained from the common bile duct and T-tube of 17 patients who also had exploration of common bile duct. During the same period, 148 cholecystectomies were performed. The specimens were sent for culture and sensitivity and 32.7% of the specimens grew bacteria. The factors that were associated with positive culture were emergency cholecystectomy for acute cholecystitis and empyema of gall bladder, carcinoma of gall bladder and obstructive jaundice. The commonest organisms were E. Coli (28.2%) and Klebsiella (17.9%). Pseudomonas surprisingly formed 10.2% of the cultured organisms. Salmonella that causes typhoid, which is an endemic disease in Ghana, formed only 7.7% of the isolates. Most of the organisms were resistant to Ampicillin and tetracyclines. The antibiotics that most were sensitive to were Gentamicin and Cefuroxime. Therefore the antibiotics that are recommended for use as prophylaxis in biliary tract surgery are Gentamicin or Cefuroxime.
胆汁取自104例因胆结石疾病接受胆囊切除术患者的胆囊。胆汁还取自17例同时接受胆总管探查患者的胆总管和T形管。在同一时期,共进行了148例胆囊切除术。标本送去做培养和药敏试验,32.7%的标本培养出细菌。与培养阳性相关的因素有急性胆囊炎和胆囊积脓的急诊胆囊切除术、胆囊癌和梗阻性黄疸。最常见的微生物是大肠杆菌(28.2%)和克雷伯菌(17.9%)。令人惊讶的是,假单胞菌占培养出微生物的10.2%。在加纳作为地方病的伤寒的致病菌沙门氏菌仅占分离菌的7.7%。大多数微生物对氨苄青霉素和四环素耐药。最敏感的抗生素是庆大霉素和头孢呋辛。因此,推荐用于胆道手术预防性使用的抗生素是庆大霉素或头孢呋辛。