Alaattin ÖZTÜRK, Hakan BOZKURTOĞLU, Cengiz KAYA, Necati TAN, Hülya ÇAŞKURLU, Ömer Faruk AKINCI

Bacteriologic analysis of bile in cholecystectomy patients

Amaç: Bu çalışmanın amacı, kolesistektomi yapılan has talarda safra kültürünün mikrobiyolojik analizini yapmak ve safra kültüründe bakteri üremesini etkileyen faktörleri değerlendirmektir. Materyal ve Metot: Prospektif ve çok merkezli olarak planlanan çalışmamızda, kolesistektomi uygulanan 114 hastanın safrası ameliyat esnasında steril şartlarda alındı, kültür ve antibiogram testleri uygulandı. Kültür sonu cunda üreyen bakterilerin cinsi belirlendi. Kültür sonucu pozitif olan hastalar, yaş, cins, teşhis, yandaş hastalıklar ve postoperatif komplikasyonlara göre değerlendirildi. Bulgular: Çeşitli sebeplerle kolesistektomi uygulanan 114 hasta çalışmaya alındı. En sık kolesistektomi sebebi kronik taşlı kolesistit (kolelitiasis)’tir. Hastaların 15’inde (%13,1) safra kültüründe bakteriyel üreme tespit edildi. En sık üreyen bakteri Enterekok türleri (4 olgu, %26,6), Escherishia coli (3 olgu, %20) ve Enterobakter (3 olgu, %20)’dir. En fazla üreme, koledok taşı ile birlikte olan akut kolesistitli hastalarda (3 olgu, %100) görüldü. Yaşı 60’dan ileri olanlarda (10 olgu, %27) ve yandaş hastalığı olan hastalarda üreme daha fazla (9 olgu, %23,6) görül dü. Tüm hastaların sadece birinde postoperatif cerrahi alan enfeksiyonu görüldü; safra kültürü pozitif olan has talarda enfeksiyöz komplikasyon görülmedi. Sonuç: Çalışmamızın sonucuna göre, safrada bakteri üremesini artıran bazı faktörler belirledik: 60’dan ileri yaş, yandaş hastalıklar ve safra stazı oluşturan durum lar. Üreyen bakteriler intestinal kaynaklıdır. Kolesistek tomi yaralarında cerrahi alan enfeksiyon riski düşüktür.

Anahtar Kelimeler:

Safra, İleriye dönük çalışma, Kolesistektomi, Kültür ortamı

Kolesistektomi yapılan hastalarda safra kültürünün mikrobiyolojik analizi

Objective: The aim of this study is to do a microbiologic analysis of bile in cholecystectomy patients and to assess the factors that contribute to bacterial growth in bile culture. Methods: This study that was designed to be prospective and include multiple centers. The bile of 114 patients that had a cholecystectomy was taken in a sterile environment during surgery and a culture with antibiogram tests was performed. Patients with positive culture results were reviewed acording to the age, sex, diagnosis, additional diseases and postoperative complications. Results: 114 patients underwent a cholecystectomy for various reasons were included in the study. Bacterial growth was detected in the bile culture of 15 patients (13.1%). The most commonly isolated bacteria were Enterococcus spp (4 patients, %26.6%), Escherishia coli (3 patients, 20%) and Enterobacter spp (3 patients, 20%). The bile culture positivity rate was highest in patients with acute cholecystitis combined with choledocolitiasis (3 patients, 100%). The bile culture bacterial growth was highest in patients over 60 years of age (10 patients, %27) and in those with concomitant illness (9 patients, 23.6%). Postoperative surgical site infection was detected in only one patient; there were no surgical site infections in patients with a positive bile culture. Conclusion: We identifed some factors that can increase the growth of bacteria in bile: age over 60, concomitant illness and some conditions causing stasis of bile.

Keywords:

Bile, Prospective Studies, Cholecystectomy, Culture Media,

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