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Biliary Bacteria, Antibiotic Use, and Wound Infection in Surgery of the Gallbladder and Common Bile Duct
Ronald T. Lewis, MB, FRCS(C);
R. Graydon Goodall, MD, FRCS(C);
Breen Marien, MD, FRCS(C);
Myung Park, MD, FRCS(C);
Walter Lloyd-Smith, MD, FRCS(C);
Frederick M. Wiegand, MD, FRCS(C)
Arch Surg. 1987;122(1):44-47.
Abstract
• That clinical risk groups predict postoperative infection in biliary operations has recently been challenged. To reevaluate the risk of infection, we studied 215 patients stratified by clinical risk factors. Of 100 patients having simple "low-risk" cholecystectomy, 11 had positive bile cultures (90% pure), and one with sterile bile got a staphylococcal wound infection (WI). Among 92 "high-risk" patients with acute cholecystitis, obstructive jaundice, or choledochal stones, 42 had positive bile cultures (44% pure, 12% anaerobes). One of 52 patients who received preoperative cefazolin got a staphylococcal WI, but ten of 40 patients without antibiotic therapy developed WIs, nine caused by organisms that also grew from the bile. Of 23 patients with obstructive cholangitis, 22 had positive bile cultures (88% mixed, 23% anaerobes). Despite antibiotic therapy, four developed WIs caused by these organisms. The concept of clinical risk factors is validated.
(Arch Surg 1987;122:44-47)
Author Affiliations
From the Department of Surgery, Queen Elizabeth Hospital and McGill University, Montreal.
Footnotes
Accepted for publication July 22, 1986.
Read before the Sixth Annual Meeting of the Surgical Infection Society, Chicago, April 22, 1986.
Reprint requests to Department of Surgery, Queen Elizabeth Hospital, 2100 Marlowe Ave, Montreal, Quebec, Canada H4A 3L6 (Dr Lewis).
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ABSTRACT
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