A PROSPECTIVE STUDY OF BACTERIOLOGIC PROFILE OF BILE IN PATIENTS UNDERGOING BILIARY SURGERIES AND ITS IMPLICATION ON PERIOPERATIVE ANTIBIOTIC REGIME AT A TERTIARY CARE CENTER

*Dr. Sony Saju, Dr. D. K. Sharma, Dr. Jitendra Singh Chouhan and Dr. Alpesh Kothari

ABSTRACT

Background: The biliary tree is a sterile system responsible for bile transport, but bacterial colonization can occur due to biliary obstruction or interventions. Bacteriobilia can lead to postoperative complications and impair hepatic function. Factors such as biliary obstruction, immunocompromised status, and prior instrumentation increase the risk of bacteriobilia. Surgical site infections in biliary surgeries result in prolonged hospital stays and higher morbidity and mortality rates. Prophylactic antibiotics are commonly used, but the variability in bile bacteriology necessitates periodic evaluation and guideline development. This study aims to determine the bacteriologic profile and sensitivity of organisms in patients undergoing biliary surgeries. Methods: The study obtained ethical committee approval and informed consent from patients. Data was collected from patients who underwent biliary surgeries at Rabindranath Tagore Medical College from June 2021 to December 2022. It was a prospective observational study using a standardized proforma to collect clinical history, investigations, operative details, and postoperative complications. Inclusion criteria included patients of any sex with biliary surgeries and intraoperative biliary sample collection, regardless of underlying pathology. Exclusion criteria included patients who refused consent, those managed conservatively, and those on prolonged preoperative antibiotic therapy. Statistical analysis was performed using Epi Info software, with p < 0.05 considered significant. Results: The manuscript presents important findings regarding bacteriobilia, biliary pathologies, and antibiotic sensitivity in a study population. The results indicate that bacteriobilia incidence varied among different age groups, with the highest prevalence in the 61-70 age group. The distribution of bacteriobilia among various biliary pathologies was also examined, with cholelithiasis being the most prevalent. Furthermore, the antibiotic sensitivity pattern for E. coli infections was investigated, highlighting the high sensitivity of amikacin. These findings contribute valuable information for understanding bacteriobilia, biliary pathologies, and guiding appropriate antibiotic treatment strategies.

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