MICROBIAL SPECTRUM AND ANTIMICROBIAL RESISTANCE IN BILE FROM PERFORATED GALLBLADDERS: SINGLE-CENTRE ANALYSIS arpadpanyko@rocketmail.com

 

MICROBIAL SPECTRUM AND ANTIMICROBIAL RESISTANCE IN BILE FROM PERFORATED GALLBLADDERS: SINGLE-CENTRE ANALYSIS

4

Slovakia

Poster Exhibition only

Acute cholecystitis with gallbladder perforation is a severe complication often associated with biliary infection. Identification of causative microorganisms is essential for targeted antimicrobial therapy and understanding local resistance patterns.

We retrospectively reviewed intraoperative bile cultures obtained from patients with perforated gallbladders. Samples were processed using standard bacteriological techniques, and antimicrobial susceptibility testing was performed according to current EUCAST guidelines.

Fifteen patients with perforated or complicated cholecystitis had intraoperative bile samples analyzed. Positive cultures were obtained in all cases. The most common isolates were Klebsiella pneumoniae (6/15, 40%) and Escherichia coli (4/15, 26.7%), followed by Enterobacter cloacae (3/15, 20%), Citrobacter freundii (3/15, 20%), and Staphylococcus epidermidis (2/15, 13.3%). Single isolates included Hafnia alvei, Staphylococcus hominis, Aeromonas sp., Aeromonas veronii, Staphylococcus haemolyticus, Clostridium perfringens, Phocaeicola vulgatus, Aeromonas caviae, Cutibacterium acnes, Staphylococcus aureus, Streptococcus parasanguinis, Streptococcus sanguinis, Enterococcus faecium, and Escherichia coli haemolytica. Notable resistance mechanisms included extended-spectrum β-lactamase (ESBL) production in E. coli and K. pneumoniae, derepressed AmpC in C. freundii, inducible AmpC in H. alvei, and methicillin resistance among coagulase-negative staphylococci. Anaerobes and less common Gram-negative organisms were present in several cases, reflecting the polymicrobial nature of severe biliary infections.

Bile from perforated gallbladders demonstrates polymicrobial growth with a predominance of Gram-negative enteric bacteria and frequent multidrug resistance. These findings underscore the importance of intraoperative sampling and local antibiogram data to guide empiric therapy in complicated cholecystitis.