Comparison of bacterial profile of gallbladder with gallstones from patients undergoing cholecystectomy due to complicated and uncomplicated cholelithiasis: changes in the epidemiological scenario.

Autor: Hirata BHN; - Faculdade de Ciências Médicas da Santa Casa de São Paulo - São Paulo - SP - Brasil., Sasagawa S; - Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Microbiologia - São Paulo - SP - Brasil., Navarini A; - Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Microbiologia - São Paulo - SP - Brasil., Mateus HC; - Hospital de Misericórdia da Santa Casa de São Paulo, Cirurgia - São Paulo - SP - Brasil., Pacheco Junior AM; - Hospital de Misericórdia da Santa Casa de São Paulo, Cirurgia - São Paulo - SP - Brasil., Salles MJC; - Hospital de Misericórdia da Santa Casa de São Paulo, Infectologia - São Paulo - SP - Brasil.
Jazyk: English; Portuguese
Zdroj: Revista do Colegio Brasileiro de Cirurgioes [Rev Col Bras Cir] 2023 Apr 28; Vol. 50, pp. e20233474. Date of Electronic Publication: 2023 Apr 28 (Print Publication: 2023).
DOI: 10.1590/0100-6991e-20233474-en
Abstrakt: Introduction: cholelithiasis is a highly prevalent disease of the digestive system in the world. In Brazil, it is a routine condition, whose studies suggest a prevalence of around 10% of adults. Colonization of bile and gallstone pathogens can occur when there is bacterial stasis and proliferation. This proliferation is facilitated by the adhesion and biofilm formation capacity of some bacteria. There are also lithogenic processes that involve bacterial participation. Studies have shown changes in the microbiota of the gallbladder of patients undergoing cholecystectomy, which may impact empirical treatment with antibiotics.
Methodology: microbiological analyzes of the sonication fluid of the gallstones and of two samples with bile were performed. Identification and antimicrobial susceptibility testing were performed according to a standard routine.
Results: of the 34 patients, 76.4% were female. The age group was 48 years +/- 16.61. Acute cholecystitis occurred in 50% of cases. Bactobilia was evidenced in 32.1% of the cases. Klebisiella pneumoniae was noted as the most prevalent pathogen in acute cholecystitis; and Enterobacter sp, in cases of uncomplicated cholelithiasis. Greater sensitivity was obtained in the search for microorganisms in the sonication fluid samples of the stones in relation to the bile samples (p=0.0058).
Conclusion: there was a higher prevalence of bactobilia in patients with acute cholecystitis compared to those with uncomplicated cholelithiasis. The use of sonication in bacterial investigation proved to be superior to the conventional method and can be considered.
Databáze: MEDLINE