Abstract
Microbial Profile and Antibiotic Sensitivity Pattern of Patients with Acute Cholangitis at a Tertiary University Hospital
Jan Bendric C. Borbe, MD; Milben A. Malbog, MD; Karla Mia G. Villena, MD; Christopher I. Gonzales, MD; Rei Joseph Prieto, MD; Eric Yasay, MD; Mark Anthony De Lusong, MD
University of the Philippines – Philippine General Hospital
Significance: Acute cholangitis is associated with a high mortality rate, ranging from 9.6% to 37%. Effective management relies on timely biliary drainage and appropriate antimicrobial therapy. The choice for empiric antibiotic treatment is heavily dependent on local antimicrobial susceptibility profiles. At present, there are not published data on the local antibiogram that is a critical component of effective therapy. This study aims to identify the microbial profiles and susceptibility patterns in patients with acute cholangitis while also analyzing the impact of culture-guided treatment on patient outcomes.
Methodology: We conducted a retrospective cross-sectional study, reviewing medical records of adults (aged 19 and above) diagnosed with acute cholangitis at a tertiary university hospital in the Philippines from Jan 2022- Dec 2024. A total enumeration was performed including all patients with confirmed cholangitis based on Tokyo guidelines who underwent endoscopic retrograde pancreatography for biliary drainage.
Results: A total of 268 patients were included in the study. The most common organisms in bile cultures were Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Resistance patterns revealed that 26% of isolates were multidrug resistant (MDR), particularly among Klebsiella pneumoniae. Notably, patients infected with MDR agents and those without bile cultures taken during biliary drainage experienced longer hospital stays. Although culture-guided treatment correlated with lower mortality rates, this difference was not statistically significant.
Conclusion: This study emphasizes the role of culture-guided therapy and the urgent need to establish a local antibiogram to inform empiric treatment strategies for acute cholangitis.
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |