During a five-year period from 1987 to 1991, 546 patients at the Department of Surgery, Chung-Ang University Hospital, undergoing operation for the biliary tract diseases had been performed intraoperative bile cultures. We analysed the 546
cases,
and
the following results were obtained:
1) The positive bacterial growth of 247 cultures among the 546 patients were 45.2 percent. But in the elderly patients(150 cases) over 60 years of age, the positive culture rate was 66 percent(P<0.005).
2) In 52 cases with acute cholecystitis, the incidence of the infected bile was 73.1 percent, and in 400 cases with gallbladder stone the positive culture rate was 36.8 per cent(P>0.1). However, the incidence of biliary sepsis in 85 cases with
choledocholithiasis was significantly high(87.1 percent, P<0.005).
3) The positive bile culture rate of the 88 patients who had acute symptoms within 1 week of the operation was 70.5 percent(P<0.05).
4) In 133 cases with leudocytosis, the positive culture rate was 64.7 per cent(P<0.005).
5) fifty-three of the 72 patients with jaundice were the positive bile cultures(73.6 percent, P<0.005).
6) Of the 103 patients whom had non-visualization of the oral cholecystogram, the positive culture rate was 55.3 percent(P<0.005).
7) The postive culture rate of bile in the 75 diabetic patients was 68.7 percent(P<0.025).
8) Escherichia coli was the most common organism in the bile cultures(33.8 percent). Next common organism was Klebsiella species(23.5 percent), and followed by the Staphylococci(11.2 percent), Enterobacter(9.5 per cent), Streptococci(7.6
percent),
and
others in small numbers. Mixed infections were found in 16 cases of the 247 positive bile cultures(6.5%). No anaerobic bacteria were found.
9) The proper sensitive antibiotics to the isolated organisms were aminoglycosides and third generation cephalosporin.
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