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Clinical Presentation and Incidence of Anaerobic Bacteria in Surgically Treated Biliary Tract Infections and Cholecystitis
Antibiotics ( IF 4.3 ) Pub Date : 2021-01-13 , DOI: 10.3390/antibiotics10010071
Jens Strohäker , Lisa Wiegand , Christian Beltzer , Alfred Königsrainer , Ruth Ladurner , Anke Meier

(1) Background: Cholecystitis and cholangitis are among the most common diseases treated by general surgery. Gallstones lead to inflammation and bacterial infection of the biliary tract. Biliary infections can lead to live threatening bacteremia and liver abscesses. The true role of anaerobes remains unclear. (2) Methods: We retrospectively analyzed bacterial cultures from biliary samples obtained from bile ducts and gallbladders at our tertiary care center. Patient characteristics and clinical outcomes were analyzed. (3) Results: In our database of 1719 patients, 365 patients had microbial testing, of which 42 grew anaerobic bacteria. Anaerobes were more frequently cultured in patients with hepatic abscesses and gallbladder perforation. These patients were older and had more comorbidities than the control group. The overall outcomes of all patients were favorable and the resistance rate to commonly used antibiotics remained low. (4) Conclusions: Anaerobes in biliary tract infections appear to be underdiagnosed and more prevalent in the elderly with advanced disease. Due to low antibiotic resistance, the combination of source control and adjunct anti-infective treatment leads to favorable outcomes.

中文翻译:

外科治疗的胆道感染和胆囊炎的厌氧细菌的临床表现和发生率

(1)背景:胆囊炎和胆管炎是普通外科手术治疗的最常见疾病。胆结石导致胆道发炎和细菌感染。胆道感染可导致活菌血症和肝脓肿。厌氧菌的真正作用仍不清楚。(2)方法:我们回顾性分析了三级护理中心从胆管和胆囊获得的胆汁样本中的细菌培养物。分析患者特征和临床结局。(3)结果:在我们的1719例患者的数据库中,有365例进行了微生物检测,其中42例生长了厌氧菌。肝脓肿和胆囊穿孔的患者厌氧菌的培养频率更高。这些患者年龄较大,合并症多于对照组。所有患者的总体预后均良好,对常用抗生素的耐药率仍然较低。(4)结论:胆道感染中的厌氧菌似乎诊断不足,并且在患有晚期疾病的老年人中更为普遍。由于低抗生素抗性,源控制和辅助抗感染治疗相结合可带来良好的疗效。
更新日期:2021-01-13
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