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The Bacteriology of Acute Cholecystitis: Comparison of Bile Cultures and Clinical Outcomes in Diabetic and Non-Diabetic Patients

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Abstract

Background

Acute cholecystitis is one of the most common acute surgical diseases. Diabetic patients have been shown to have an increased risk for gallbladder disease, but the correlation between the severity of gallstone disease and diabetes is still debated. The aim of this study is to examine the possible difference in the disease process between patients with diabetes mellitus (DM) and those without.

Patients and methods

A retrospective study was conducted of all patients who underwent percutaneous cholecystostomy between 2005 and 2015 at Emek Medical Center, Afula, Israel. Demographic and medical history including data on bile and blood culture results, antimicrobial susceptibility, and clinical outcomes were retrieved from patient files.

Results

The cohort included 272 patients. Mean age was 68 years old, 50.74% were male and 43.75% had diabetes mellitus. Bile cultures were obtained from 252 (92.64%) patients and were positive in 134 (53.2%) patients. In 11 patients (4%) two pathogens were isolated. Blood cultures obtained from 231 patients and were positive in 35 (15.2%). Escherichia coli was the most common isolate, and was seen in 22.3% of positive bile cultures and 40% of blood cultures. Although diabetic patients had significantly more positive bile cultures, the severity of the disease, according to the Tokyo guidelines, was not higher.

Conclusions

Acute cholecystitis was neither more severe nor had significant difference in bacteriological properties when comparing diabetic patients to non-diabetic ones.

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Author information

Author notes

  1. Uri Kaplan and Chovav Handler Equal contribution to the research

Authors and Affiliations

  1. Department of General Surgery B, Emek Medical Center, Yitzhak Rabin Boulevard 21, 1834111, Afula, Israel

    Uri Kaplan, Chovav Handler, Noam Weiner, Ossama A. Hatoum & Doron Kopelman

  2. Infectious Disease Unit, Emek Medical Center, Yitzhak Rabin Boulevard 21, 1834111, Afula, Israel

    Bibiana Chazan & Anna Yanovskay

  3. Rappaport Faculty of Medicine, Technion–Israel Institute of Technology,, Efron st. 1, Bat Galim,, 3525433, Haifa, Israel

    Bibiana Chazan, Ossama A. Hatoum, Anna Yanovskay & Doron Kopelman

Authors
  1. Uri Kaplan
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  2. Chovav Handler
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  3. Bibiana Chazan
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  4. Noam Weiner
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  5. Ossama A. Hatoum
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  6. Anna Yanovskay
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  7. Doron Kopelman
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Corresponding author

Correspondence to Uri Kaplan.

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The authors declare that they have no conflict of interest.

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The studies have been approved by the appropriate institution review board (IRB).

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Kaplan, U., Handler, C., Chazan, B. et al. The Bacteriology of Acute Cholecystitis: Comparison of Bile Cultures and Clinical Outcomes in Diabetic and Non-Diabetic Patients. World J Surg 45, 2426–2431 (2021). https://doi.org/10.1007/s00268-021-06107-2

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  • DOI: https://doi.org/10.1007/s00268-021-06107-2

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