Objective: This study is aimed to provide a clinical basis for the identification and treatment of patients with malignant biliary obstruction (MBO) complicated with biliary infection by comparing pathogenic bacteria detected in bile and blood cultures from these patients.
Materials and Methods: A total of 380 patients with MBO who received percutaneous transhepatic cholangic drainage from January 2004 to January 2019 were included in the study. A total of 90 patients were diagnosed with having MBO complicated with biliary infection, and bile and blood culture were simultaneously performed on these patients. The patients included 58 men and 32 women, ranging in age from 33 to 86 years old, with a mean age of 60.69 years.
Results: The detection rate using bile bacterial culture in patients with MBO complicated with biliary infection was significantly higher than that using blood culture, and there were significant differences in the two kinds of bacterial culture found positive bile and blood cultures from the same patients. Gram-positive cocci were dominant in the bile cultures and Gram-negative bacilli were dominant in the blood cultures. Therefore, it is necessary to conduct simultaneous bile bacterial culture and blood culture for patients with MBO complicated with biliary infection, especially those with severe or critical diseases.
Conclusions: It is vital to enable simultaneous bile bacterial culture and blood culture in patients with MBO complicated with biliary infection. Existing guidelines for the diagnosis and treatment of benign biliary infection are not applicable to patients with MBO complicated with biliary infection.


中文翻译：

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恶性胆道梗阻合并胆道感染患者胆汁培养与血培养比较分析


目的：本研究旨在通过比较患者胆汁和血培养中检出的病原菌，为恶性胆道梗阻（MBO）合并胆道感染患者的鉴别和治疗提供临床依据。
材料与方法：本研究共纳入 2004 年 1 月至 2019 年 1 月接受经皮经肝胆管引流的 MBO 患者 380 例。共有90例患者被诊断为MBO合并胆道感染，同时对这些患者进行了胆汁和血培养。患者中男58例，女32例，年龄33～86岁，平均60.69岁。
结果：MBO合并胆道感染患者胆汁细菌培养检出率明显高于血培养，两种细菌培养发现胆汁阳性和同一患者血培养存在显着差异。革兰氏阳性球菌在胆汁培养中占优势，革兰氏阴性杆菌在血培养中占优势。因此，对于合并胆道感染的MBO患者，尤其是重症或危重症患者，需要同时进行胆汁细菌培养和血培养。
结论：对合并胆道感染的 MBO 患者同时进行胆汁细菌培养和血液培养至关重要。现有的良性胆道感染诊断和治疗指南不适用于合并胆道感染的MBO患者。