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Varna Medical Forum

Etiological spectrum and susceptibility to antibiotics of the leading bacterial causative agents of acute cholangitis

Milena Bozhkova, Temenuga Stoeva, Vasil Bozhkov, Tsevetelina Kostadinova-Popova, Rosen Madzhov


The complex approach to the diagnosis and treatment of acute cholangitis requires knowledge about the spectrum of involved bacteria and their susceptibility to antibacterial drugs. The study provides information about bacterial pathogens, isolated from bile specimens of patients with acute cholangitis and their in vitro antibiotic susceptibility. The major causative agent of the disease are Gram-negative bacteria - mainly E. coli, presented in 26.8% of all tested samples. Among Gram-positive bacteria, the proportion of enterococci (E. feacalis and E. faecium) is the highest. The highest levels of resistance was detected for aminopenicillins - 63.5%. Imipenem, piperacillin/tazobactam, ciprofloxacin and gentamicin demonstrated the highest in vitro activity with resistance levels 2.8%, 14.8%, 14.6% and 15.7%, respectively.


acute cholangitis; etiology; antibiotic resistance

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Хаджиева Н., Д. Иванова. Микробиологични аспекти на инфекциите на жлъчните пътища. В: Инфекции на жлъчната система. Хирургическо лечение. Под редакцията на проф. Д. Дамянов. „Медарт”- СУБ, 2004, с. 9-20.

Brooke I. Aerobic and Anaerobic Microbiology of Biliary Tract Disease. Journal of clinical microbiology, 1989, 27, 2373-2375

Goo J. C. еt all. Extended Spectrum-β-Lactamase or Carbapenemase Producing Bacteria Isolated from Patients with Acute Cholangitis .Clin Endosc 2012;45:155-160

Karpel E, Madej A, Bułdak Ł, Duława-Bułdak A, Nowakowska-Duława E, Łabuzek K, Haberka M, Stojko R, Okopień B. Bile bacterial flora and its in vitro resistance pattern in patients with acute cholangitis resulting from choledocholithiasis. Scand J Gastroenterol. 2011;46:925-930

Kaya M., R. Beştaş, F. Bacalan, F. Bacaksız et al Microbial profile and antibiotic sensitivity pattern in bile cultures from endoscopic retrograde cholangiography patients. World J Gastroenterol 2012 ; 18: 3585-3589

Lipsett P. A & H. A. Pitt: Acute cholangitis. Surg Clin N Am ,1990, 70, 1297-1312

Pitt H. A & W P Longmire Jr: Suppurative cholangitis. In: Hardy J M. Ed: “Critical Surgical Illness.” Ed 2: Sanders W B, Philadelphia 1980, 380

Sahu MK, Chacko A, Dutta AK, Prakash JA. Microbial profile and antibiotic sensitivity pattern in acute bacterial cholangitis. Indian J Gastroenterol. 2011;30:204-208.,

Sakaguchi Y., K. Murata & M. Kimura: Clostridium perfringens and other anaerobes isolated from bile. J Clin Pathol ,1983, 36, 345-349

Sung JJ, Lyon DJ, Suen R, Chung SC, Co AL, Cheng AF, Leung JW, Li AK. Intravenous ciprofloxacin as treatment for patients with acute suppurative cholangitis: a randomized, controlled clinical trial. J Antimicrob Chemother 1995; 35: 855-864

Tanaka А. et all. Antimicrobial therapy for acute cholangitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg ,2007, 14:59–67



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