ANTIBIOTIC SENSITIVITY SPECTRUM OF ACUTE BACTERIAL CHOLANGITIS: TRENDS FROM A TERTIARY REFERRAL CENTER IN PAKISTAN
DOI:
https://doi.org/10.55519/JAMC-01-12930Keywords:
Antibiotic Resistance, Acute Cholangitis, Bacterial Cholangitis, Antibiotic StewardshipAbstract
Background: Significant morbidity can arise from acute bacterial cholangitis. Key to improving outcomes is the implementation of aggressive antibiotic therapy and prompt biliary decompression through either endoscopic or percutaneous means. However, the challenge in treating these infections is amplified by the evolving patterns of antimicrobial resistance, particularly when determining the appropriate empiric therapy. Methods: The present study was conducted at Shifa International Hospital in Islamabad. The patients with the diagnosis of Acute bacterial cholangitis between July 2016 and June 2022 were included. Data was analyzed using SPSS-26.0 to identify any significant associations or correlations among the study variables. Results: A total of 144 patients with a diagnosis of acute bacterial cholangitis were included in the study. 51 of these patients had a positive blood culture. The most commonly identified organism was E. coli, followed by Klebsiella pneumonia, Pseudomonas aeruginosa, Proteus, Enterococcus spp and others. Antibiotic sensitivity pattern revealed resistance to Ceftazidime in 87%, Piperacillin-Tazobactam in 63.7%, Ertapenem in 34.4%, Meropenem in 26.1%, Imipenem in 25.0% and Colistin in 16.1%. Conclusion: A high resistance pattern for antibiotics was observed in our study. This might, in turn, represent the prior judicious use of antibiotics in our community hospitals before these patients are referred to a tertiary referral center.References
Kruis T, Güse-Jaschuck S, Siegmund B, Adam T, Epple HJ. Use of microbiological and patient data for choice of empirical antibiotic therapy in acute cholangitis. BMC Gastroenterol 2020;20(1):65.
Ahmed M. Acute cholangitis - an update. World J Gastrointest Pathophysiol 2018;9(1):1–7.
Sokal A, Sauvanet A, Fantin B, de Lastours V. Acute cholangitis: Diagnosis and management. J Visc Surg 2019;156(6):515–25.
Kaya M, Beştaş R, Bacalan F, Bacaksız F, Arslan EG, Kaplan MA. Microbial profile and antibiotic sensitivity pattern in bile cultures from endoscopic retrograde cholangiography patients. World J Gastroenterol 2012;18(27):3585–9.
Sahu MK, Chacko A, Dutta AK, Prakash JA. Microbial profile and antibiotic sensitivity pattern in acute bacterial cholangitis. Indian J Gastroenterol 2011;30(5):204–8.
Chandra S, Klair J, Soota K, Livorsi DJ, Johlin FC. Endoscopic Retrograde Cholangio-Pancreatography-Obtained Bile Culture Can Guide Antibiotic Therapy in Acute Cholangitis. Dig Dis 2018;37(2):155–60.
Shafagh S, Rohani SH, Hajian A. Biliary infection; distribution of species and antibiogram study. Ann Med Surg (Lond) 2021;70:102822.
Kimura Y, Takada T, Kawarada Y, Nimura Y, Hirata K, Sekimoto M, et al. Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg 2007;14(1):15–26.
Du M, Suo J, Liu B, Xing Y, Chen L, Liu Y. Post-ERCP infection and its epidemiological and clinical characteristics in a large Chinese tertiary hospital: a 4-year surveillance study. Antimicrob Resist Infect Control 2017;6:131.
Verdier J, Luedde T, Sellge G. Biliary Mucosal Barrier and Microbiome. Viszeralmedizin 2015;31(3):156–61.
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