J.Jpn. Surg. Soc.. 80(8): 717-734, 1979
Original article
BACTERIOLOGICAL STUDIES ON CHOLELITHIASIS WITH SPECIAL REFERENCE TO ANAEROBIC ORGANISMS
|
The 1st Department of Surgery, Nippon Medical School Masaru Yamakawa |
69.7% of these patients (67.2% of 134 cultures performed) yielded bacteria on culture of bile. 28.6% yielded anaerobic bacteria, either in pure culture (1.7%) or in mixed culture with aerobic bacteria (26.9%). Bacteroides fragilis were most frequently isolated (24.7%), being mixed mainly with E. coli in culture. The gallbladder-and common bile duct-bile mixed infected with these aerobic and anaerobic bacteria were found in 36.0% and 75.0% of cases with acute cholecystitis, whereas in 20.7% and 34.8% with chronic cholecystitis, respectively. The occurence of aerobic and anaerobic bacteria in bile significantly related to fever, white blood cell counts and histopathologic changes of gallbladder, whereas no significant relation was found to qualitative liver function tests.
The survival time of rabbits with experimental biliary tract obstruction was significantly shortened by combined inoculation of Bacteroides fragilis and E. coli into obstructed bile ducts in comparison with single inoculation of these bacteria. Seven days after the obstruction (two days after the bacterial inoculation), Bacteroides fragilis and E. coli were cultured from blood in 22.2% of combined inoculated animals. However, Limulus tests were positive in high percentage (40.0% in peripheral vein, 66.7% in portal vein). The pathological findings of liver and gallbladder in these animals revealed more significant damage than those in single inoculated animals.
It was concluded that anaerobic organisms such as Bacteroides fragilis may play a significant role in biliary tract infection with contamination of gram-negative aerobic bacteria.
To read the PDF file you will need Adobe Reader installed on your computer.