Indexing
CÁC SỐ TỪ 2011-2023
Tạp chí Y Dược Học
Abstract
ABSTRACT
Background: Acute cholangitis is a common disease in Vietnam as well as worldwide. The disease has a complex clinical course and can lead to many severe complications, even death, if it is not diagnosed and treated promptly. In order to improve the quality and effectiveness of treatment, we conducted a study collecting data from patients with acute cholangitis who underwent bile culture, with the following objectives: to describe the bacteriological characteristics, antibiotic susceptibility patterns, and clinical response rates, as well as to evaluate the concordance between empiric antibiotic therapy and antibiotic susceptibility results in acute cholangitis.
Materials and Methods: From January 2025 to August 2025, there were 77 cases of cholangitis in which aerobic bile cultures were performed. The bile samples were cultured, identified, and tested for antibiotic susceptibility using the BD Phoenix M50 automated system, in order to accurately determine the causative pathogens and assess the antimicrobial susceptibility of each bacterial isolate.
Results: The mean age of patients in the study was 63.3 years. The bile culture positivity rate was 87%, among which Escherichia coli was the most common causative pathogen (45.5%), followed by Klebsiella pneumoniae (20.8%). Gram-negative bacteria remained highly susceptible to antibiotics such as ceftazidime/avibactam (87.5%), amikacin (81.3%), and tigecycline (75.0%), as well as carbapenems (imipenem, meropenem). The clinical response rate after 48–72 hours was 62.3%. The rate of concordance between initial empiric antibiotic therapy and antibiotic susceptibility testing was 51.9%. The overall treatment response rate reached 92.2%.
Conclusion: The two most common pathogens in acute cholangitis were Escherichia coli and Klebsiella pneumoniae. Gram-negative bacteria showed high resistance rates to fluoroquinolones (ciprofloxacin) and third-generation cephalosporins (ceftazidime, ceftriaxone), with a concerning rate of carbapenem resistance among Klebsiella pneumoniae (>30%). No association was found between the type of pathogen and disease severity. Inappropriate initial antibiotic therapy may not adversely affect overall treatment outcomes if early biliary drainage is performed and antibiotics are adjusted appropriately in a timely manner. In addition, the clinical response to antibiotic therapy after 48–72 hours is an important indicator of final treatment outcomes.
Keywords: Acute cholangitis, bacteriological characteristics , clinical response to antibiotic therapy.
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