Microbiological Spectrum, Antibiogram and Bacteraemia in Biliary Tract Infections- A Study from Tertiary Centre of North India

Objectives: The present study was undertaken to understand the microbiological profile, clinical presentation, associated bacteraemia and present antibiogram pattern of various isolates from patients with biliary tract infection admitted in a tertiary care centre in India.

Methods: In this retrospective study, Bile samples were collected from adult patients admitted in our hospital and were processed as per standard protocol. The results were interpreted as per Clinical Laboratory Standards Institute (CLSI) 2020 guidelines. Bacterial isolates were categorised as MDR and PDR as per CDC.

Results: 326 bile samples were sent for aerobic culture and susceptibly testing. 197 (60.42%) of these samples were culture-positive, and the remaining 129 (39.57%) were sterile in nature. A total of 289 pathogens were isolated; Escherichia coli (37.37 % n=108) was predominant, followed by Klebsiella pneumoniae (25.60%, n=74). 170 (60.49%) isolates were resis­tant and the remaining 111 (39.50%) were susceptible to various drugs tested. 27 ESBL producing strains of E.coli( n= 20) and Klebsiella spp (n= 7) and 21 CRE producing strains of E coli ( n= 12) and Klebsiella spp( n=9) were reported . 5 isolates of Klebsie­lla spp. and a single E.coli were PDR and susceptible to colis­tin (MIC =0.5 mcg/ml) by microbroth dilution test.

Conclusion: The soaring rates of infection mainly by gram-negative bacteria are a red flag with the emergence of multidrug resistant organisms and change in the anti-microbiological spectrum and pattern of biliary tract infections, there is an urgent need for the empirical and prophylactic an­timicrobial therapy in every clinical setting.