Biliary bacteria: significance and alterations after antibiotic therapy
H. A. Pitt, R. G. Postier and J. L. Cameron
Patients undergoing urgent and complex biliary operations were studied to
determine (1) whether bactibilia is associated with postoperative
complications amd (2) whether antibiotic therapy influences biliary
bacteriology. Aerobic and anaerobic cultures were performed on hepatic bile
obtained at surgery in 134 patients. Cultures were repeated four to seven
days postoperatively in 111 patients who had indwelling biliary tubes.
Positive operative bile cultures were associated with an increased
incidence of wound infection and postoperative renal dysfunction.
Postoperative bile cultures showed a significant increase in the number of
patients having bactibilia, and a significant alteration in the types of
organisms isolated. Anaerobes were cultured from 15% of operative and 23%
of postoperative cultures. Antibiotic therapy did not sterilize bile, but
merely altered biliary bacteriology. Furthermore, prolonged aminoglycoside
therapy was associated with a high incidence of renal dysfunction,
especially in elderly patients.
