Usefulness of ERCP Bile Aspirated Culture in Patients With Acute Cholangitis

C Burciu; I Sporea; I Ratiu; T Moga; F Bende; Ghiuchici AM; R Mare; B Miutescu

doi:10.1055/s-0041-1724374

Endoscopy, Table of Contents

Endoscopy 2021; 53(S 01): S48-S49
DOI: 10.1055/s-0041-1724374

Abstracts | ESGE Days

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Friday, 26 March 2021 12:00 – 12:45 Optimising outcomes of ERCP Room 6

Usefulness of ERCP Bile Aspirated Culture in Patients With Acute Cholangitis

Authors

C Burciu

¹Victor Babes University of Medicine and Pharmacy, Gastroenterology and Hepatology, Timisoara, Romania
I Sporea

¹Victor Babes University of Medicine and Pharmacy, Gastroenterology and Hepatology, Timisoara, Romania
I Ratiu

¹Victor Babes University of Medicine and Pharmacy, Gastroenterology and Hepatology, Timisoara, Romania
T Moga

¹Victor Babes University of Medicine and Pharmacy, Gastroenterology and Hepatology, Timisoara, Romania
F Bende

¹Victor Babes University of Medicine and Pharmacy, Gastroenterology and Hepatology, Timisoara, Romania
Ghiuchici AM

¹Victor Babes University of Medicine and Pharmacy, Gastroenterology and Hepatology, Timisoara, Romania
R Mare

¹Victor Babes University of Medicine and Pharmacy, Gastroenterology and Hepatology, Timisoara, Romania
B Miutescu

¹Victor Babes University of Medicine and Pharmacy, Gastroenterology and Hepatology, Timisoara, Romania

Abstract

Full Text

Aims Targeted antimicrobial therapy can favour good clinical outcomes and can avoid recurrence of infection and early stent occlusion in patients with acute cholangitis. This study compares the microbial yield of blood cultures and bile aspirate cultures in patients with ascending cholangitis.

Methods We reviewed the medical records of patients suspected of acute cholangitis in our Endoscopy Department between June 2018 and December 2020. All patients underwent ERCP and bile culture was aspirated during the procedure. We divided the patients according to their severity of cholangitis from 2018 Tokyo Guidelines (TG18) and the microorganism found in the bile culture. Finally, we compared the bile culture findings with the blood culture.

Results 128 patients were included in this study, with a mean age of 69.5 ± 14.1 years old. The male to female ratio was 1.06. Bile culture was sterile in 28/128 (21.9 %). E. Coli was involved in 54/100 (54 %), Klebsiella in 31/100 (31 %) and Enterococcus in 16/100(16 %) of the cases. Cultures from the biliary aspirate grew single organism in 63 patients (63 %), two organisms in 31 patients (31 %) and three organisms in 6 patients (6 %). The sterile bile culture rate decreased with the increasing severity of acute cholangitis: TG18 grade I (mild) 7/30 (23.3 %) vs. grade II (moderate) 15/67 (22.4 %) vs grade III (severe) 6/31 (19.4 %). Two organisms or more were found in 56 % of severe (grade III) acute cholangitis compared to mild and moderate cases, 30.4 % and 29.2 %, respectively. 24 patients had positive blood and bile culture. 17/24 (70.8 %) had involved the same organism and 7/24 (29.2 %) had different microorganisms involved. More than half of the sterile blood cultures (60.3 %) are positive in bile culture.

Conclusions ERCP guided bile culture is a reliable tool for targeted antimicrobial therapy with a higher sensitivity when compared to blood culture.

Citation: Burciu C, Sporea I, Ratiu I et al. OP115 USEFULNESS OF ERCP BILE ASPIRATED CULTURE IN PATIENTS WITH ACUTE CHOLANGITIS. Endoscopy 2021; 53: S48.