Cultivation And Drug Sensitive Test Of Bile Pathogen In Patients With Biliary Tract Disease During Endoscopic Retrograde Cholangiopancreatography

Objective: To survey the biliary pathogens and their sensitivity toantibiotics in patients with biliary tract disease to serve as a guidance inmedication， and to explore the relationship between the positive rate ofgermiculture and some influence factors.Methods: Bile specimens collected from104patiants with biliary tractdisease during endoscopic retrograde cholangiopancreatography（ERCP） fromJanuary2008to Auguest2011were cultured and tested for drug sensitivity tobacteria.The results were statistically analyzed.Results: Among104bile specimens,70ones were positive in germicultruewith a positive rate of67.3%. Fifty-eight Gram-negative bacteria (74.4%),18Gram-positive bacteria (23.1%) and2fungus (2.6%) were included in78bacterial strains belonging to13species. The two most common pathogens wereEscherichia coli (53.8%) and Klebsiella pneumoniae (9.0%). Patients who wereolder than60had a higher positive rate(76.9%) of germiculture than who wereyounger than60(57.7%). Patients who had signs of infection had a higherpositive rate(82.9%) in germiculture. The bile positive germiculture rate of benign biliary disease was71.4%,which was higher than that of malignantbiliary disease. Patients who had an operation on biliary tract before ERCP had ahigher positive rate(81.0%). Drug sensitivity test showed that Gram-negativebacteria were sensitive to meropenem, amikacin，imipenem, Piperacillin/taz andCefoperazone/sul.Gram-negative bacteria were highly resistant to Piperacillin，cotrimoxazole, cipronoxacin, levofloxacin and cefotaxime. None of theGram-positive bacteria were resistant to Vancomycin, linezolid and teicoplanin.The resistant rates of Gram-positive bacteria to erythromycin, doxycycline andgentamicin was50%.Conclusions: Agedness,signs of infection,benign biliary tract disease,andbiliary surgery history are significantly associated with the higher positive ratein germiculture. The predominant pathogens in patients with biliary tract diseaseare Escherichia coli and Klebsiella pneumoniae, which have a high resistant rateto the commonly used antibiotics. Bile germicultrue and drug sensitivity testshould be paid attention to for the purpose of therapy guiding.