J.Jpn. Surg. Soc.. 58(8): 1217-1228, 1957

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BACTERIOLOGICAL STUDIES OF CHOLECYSTITIS
Ⅰ. FREQUENCY OF POSITIVE DEMONSTRATION OF BACTERIA AND STRAINS OF SUCH BACTERIA

Bacteriological studies have been made on 118 cases of cholecystitis operated in the Department of Surgery, Nihon Medical Sohool, during past 3 years, in which the frequency of positive demonstration of bacteria and the determination of their strains have been attempted. The results obtained are as follows:
1. Bacteria were demonstrated in the bile of 85 (72 per cent) of 118 patients with cholecystitis, the figure slightly lower than the average positive rate in the reported cases in this country. The frequency in 88 cases of cholecystitis associated with cholelithiasis was 79 per cent (70 cases), which is fairly high. No significant differences were noted in the bacterial frequency according to the location of gall stones. Relatively high rates were found in cases of bile-duct stones (88%) and of stones in bile duct and gall-bladder (95%), while in those of gall-bladder stones the positive rate was 72%.
2. The microorganisms isolated from 59 cases of bacteria-containing bile were of coliform group showing an overwhelmingly high incidence of 86% (50 cases) followed by staphylococci (6 cases, 10%), streptococci (3 cases, 5%), anaerobes (6 cases 10%) and diplococci (4 cases 7%), all being rather low in frequency.
The anaerobic bacteria comprised, strain each of B. oedematiens, B. bifidus, Streptobacillus, Streptobacillus caviae, and 2 strains of taphylococcus gelatinolyticus, a total of 6 strains from 5 species. Not one strain of Clostridium welchii, which has been often reported, was never encountered in the present series.
3. The proliferation of coliform group was extremely good in the bile of cholecystitis patients. This was particularly marked in those presenting acute symptoms, the bacterial count varying from 10⁷-10⁸, but decreased during the intermittent of chronic stage.
The coli bacilli isolated from the present cases may be classified according to the lmvic system as follows : Escherichia coli type I. (89%) which was remarkably high, while Escherichia coli type II. (15%), Aerobacter aerogenes type I. (21%), Aerobacter aerogenes type II. (21%), the intermediate type II. (5%), all being very low.
Classification of Escherichia type I. by means of O-serum revealed only the strains isolated from 2 acute cases of 10 patients were found to be classifiable, namely 0-6 and 0-12 respectively.
(author's abstract)

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