Microbiological Picture of Bile at Primary and Repeated Endobiliary Interventions and its Role in Defning Rational Antibiotic Terapy

Introduction. Te number of studies comparing the levels of bacterial contamination of the biliary tree and the sensitivity of the resulting bacteria to antibiotics in cultures of bile obtained from primary and repeated endoscopic retrograde cholangiography (ERCG) is extremely limited, but the study of this issue can signifcantly affect the tactics of treating obstructive jaundice.

Te purpose of the study. Compare the microbiological picture of bile and the sensitivity of the main pathogens to antibiotic therapy in primary and repeated endobiliary interventions with the determination of the clinical signifcance of the method.

Study material and methods. Te study included 43 patients with ERCG with  strictures of the terminal choledochus (20 patients with a history of ERCG, 23 patients with frst-time ERCG). Te titers of the identifed pathogens and the sensitivity of the main pathogens to antibiotic therapy were compared.

Outcomes. 86,96 % of positive cultures were detected during primary interventions and 100 % during repeated ones. Te most common bacteria are Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae). Obligate anaerobes were not detected in any of the cases. E. coli and K. pneumoniae have shown polyresistance to most antibacterial drugs.

Conclusion. Te introduction of bile sampling during endobiliary interventions for microbiological analysis with the determination of sensitivity to antibiotics in clinical practice can signifcantly affect the choice of empirical and etiotropic antibiotic therapy and improve treatment outcomes. Te polyresistance of bacteria determines the importance of conducting similar studies in other hospitals in order to rationally prescribe antibacterial drugs

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