During a three-year period, 600 patients were admitted to the Asan Medical Center because of biliary tract diseases. Both aerobic and anaerobic cultures were performed in 313 patients with cholangitis (bile:253, blood:113, both:53). Of these
patients,
189 were positive(bile 159. blood 68. both 38). The most common organisms were E. coli, K pneumoniae, and P. aeruginosa in both bile(respectively, 49.7%, 20.8%, 51.5%) and blood cultures(respectively, 45.6%, 26.5%, 22.1%). Anaerobes were present
in
1.5%
of positive blood cultures and 1.3% of positive bile cultures. Antibiotic therapy did not sterilize bile, but selectively increased the proportions of P. aeruginosa. There was no significant difference in biliary bacteriology according to the
history of
biliary surgery, or the presence of percutaneous biliary drainage or underlying disease. More than 95% of gram-negative organisms isolated was highly susceptible to imipenem and amikacin. P. aeruginosa was resistant to ceftazidime in 63.3% which
might
be associated with overuse of the drug during the study period. Further studies will be necessary in patients with cholangitis to determine whether newer antibiotics replace previous combination therapy.
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