ANALYSIS OF BACTERIAL CHOLANGITIS IN PATIENTS ATTENDING TERTIARY HEALTH CARE CENTRE IN NORTH INDIA

MANODEEP SEN¹, VIKRAMJEET SINGH², ANUPAM DAS³*, JAYA GARG⁴, ANSHUMAN PANDEY⁵, JYOTSNA AGARWAL^6
1Professor, Department of Microbiology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
²Senior Resident, Department of Microbiology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
³Associate Professor, Department of Microbiology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
⁴Associate Professor, Department of Microbiology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
⁵Professor & Head, Department of Gastrosurgery, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
⁶Professor & Head, Department of Microbiology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
* Corresponding Author : dasdranupam@gmail.com

Received : 06-06-2018     Accepted : 16-06-2018     Published : 30-06-2018
Volume : 10     Issue : 6       Pages : 1256 - 1258
Int J Microbiol Res 10.6 (2018):1256-1258
DOI : http://dx.doi.org/10.9735/0975-5276.10.6.1256-1258

Keywords : Bile culture, cholangitis, ESBL
Conflict of Interest : None declared
Acknowledgements/Funding : Author thankful to Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
Author Contribution : All author equally contributed

Introduction: Acute bacterial cholangitis is defined as infection either in the inflamed biliary ductal system or in the biliary obstruction. The rational of this study was to identify the microbiological organisms responsible for causing biliary cholangitis and the emergence of drug resistance in these organisms. Materials and Methods: This retrospective study was done in the Department of Microbiology of Tertiary care Super speciality Hospital in North India. All cases of cholangitis due to various causes were included during the study period. Bile samples from clinically suspected cholangitis cases were collected under sterile conditions and standard bacteriological tests were performed for identification and appropriate statistical methods were employed. Result: In the present study involving 175 patients, 57% presented with acute cholangitis, 38% with chronic cholangitis and 5% with malignancy. A total of 50.3% of the bile samples among suspected cholangitis patients were positive for aerobic culture. Gram negative bacteria were the predominant pathogens responsible for cholangitis than Gram positive bacteria. Escherichia coli (52.1%) was the predominant microorganism among Gram positive and Gram-negative bacteria followed by Pseudomonas aeruginosa (9.6 %) and Acinetobacter baumannii (8.5%). Polymicrobial infection was reported in 3.2% of the bile culture positive cases of cholangitis. Conclusion: Gram negative bacteria demonstrated maximum resistance to β-lactam group and cephalosporin group of drugs followed by aminoglycosides. Emerging multiple drug resistance strains and polymicrobial etiology reflects therapeutic failure. Incorporating a proper antibiotic policy can help clinicians in early and prompt treatment of cholangitis cases.

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