Cultivation-based characterization of biliary microbiota in bile samples collected during routine endoscopic retrograde cholangiography: 10 years of experience at a tertiary center
Kilian Forster, Friederike Klein, Nicolas Simon, Patrick Chhatwal, Stefan Ziesing, Benjamin Heidrich, Philipp Solbach- Gastroenterology
- Hepatology
Introduction
Bile has long been considered sterile. Recent studies show that bacteria can frequently be detected in bile and certain bacterial species are associated with bile duct-associated liver disease.
Objectives
To detect bacterial species and antibiotic resistance in bile in bile duct-associated liver disease.
Methodology
To evaluate microbiological findings of bile samples obtained during ERCP at a tertiary center from 2009 to 2019.
Results
There were 1885 bile samples from 992 patients examined by cultural microbiological analysis. Germs were detected in 91% of the samples. Most bile samples (n) were obtained from patients who had undergone liver transplantation (LTX; n = 556), followed by patients with primary sclerosing cholangitis (PSC; n = 287). Enterococci were detected in 67% of samples, followed by E. coli (32.2%) and Klebsiella (28.2%). Of 1151 enterococci detected, 13.1% were vancomycin (VRE)s and of 216 staphylococci detected, 10% were ORSA. The proportion of VRE increased with the number of tests performed during ERCPs (
Conclusion
Knowledge of the bacterial composition of bile in various bile duct-associated liver diseases may allow more targeted antibiotic use in the future.