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Bile Culture and Susceptibility Testing of Malignant Biliary Obstruction via PTBD

  • Clinical Investigation
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Abstract

Purpose

To assess the information obtained by bile culture and susceptibility testing for malignant biliary obstruction by a retrospective one-center study.

Methods

A total of 694 patients with malignant biliary obstruction received percutaneous transhepatic biliary drainage during the period July 2003 to September 2010, and subsequently, bile specimens were collected during the procedure. Among the 694 patients, 485 were men and 209 were women, ranging in age from 38 to 78 years (mean age 62 years).

Results

A total of 42.9% patients had a positive bile culture (298 of 694). Further, 57 species of microorganisms and 342 strains were identified; gram-positive bacteria accounted for 50.9% (174 of 342) and gram-negative bacteria accounted for 41.5% (142 of 342) of these strains. No anaerobes were obtained by culture during this study. The most common microorganisms were Enterococcus faecalis (41 of 342, 11.9%), Escherichia coli (34 of 342, 9.9%), Klebsiella pneumoniae (28 of 342, 8.2%), Staphylococcus epidermidis (19 of 342, 5.5%), Enterococcus (18 of 342, 5.3%), and Enterobacter cloacae (16 of 342, 4.7%). The percentage of β-lactamase-producing gram-positive bacteria was 27.6% (48 of 174), and the percentage of gram-negative bacteria was 19.7% (28 of 142). The percentage of enzyme-producing Escherichia coli was 61.7% (21 of 34).

Conclusion

The bile cultures in malignant biliary obstruction are different from those in the Tokyo Guidelines and other benign biliary obstruction researches, which indicates that a different antibacterial therapy should be applied. Thus, knowledge of the antimicrobial susceptibility data could aid in the better use of antibiotics for the empirical therapy of biliary infection combined with malignant biliary obstruction.

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Acknowledgments

We thank Michael J. Wallace, MD, of The University of Texas MD Anderson Cancer Center, for his suggestions. We also thank Dr. Zhang Peng and Dr. Li Ding in the Laboratory Department of Tianjin Medical University Cancer Institute and Hospital for their help with this research. Supported by the China National Science & Technology Pillar Program during the Eleventh 5-Year Plan Period (2007BAI05B06) and Tianjin City Higher Education Science & Technology Fund Planning Project.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Interventional Therapy, Tianjin Key Cancer Prevention and Treatment Laboratory, Tinajin Medical University Cancer Institute and Hospital, Tianjin, 300060, People’s Republic of China

    Haipeng Yu, Zhi Guo, Wenge Xing, Xiuying Guo, Fang Liu & Baoguo Li

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  1. Haipeng Yu
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  2. Zhi Guo
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  3. Wenge Xing
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  4. Xiuying Guo
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  5. Fang Liu
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Correspondence to Zhi Guo.

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Yu, H., Guo, Z., Xing, W. et al. Bile Culture and Susceptibility Testing of Malignant Biliary Obstruction via PTBD. Cardiovasc Intervent Radiol 35, 1136–1144 (2012). https://doi.org/10.1007/s00270-011-0263-2

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  • DOI: https://doi.org/10.1007/s00270-011-0263-2

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