Analysis of pathogenic bacteria in bile and blood of patients with obstructive jaundice

Objective To investigate the distribution of pathogenic bacteria in the bile and blood samples of patients with obstructive jaundice.Methods A total of 322 patients with obstructive jaundice who were admitted to Department of Gastroenterology and Department of Hepatobiliary Surgery in The Affiliated Hospital of Binzhou Medical University from January 2012 to April 2016 were enrolled.Bile samples were obtained from all patients and blood culture was performed for 84 patients.The influence of benign and malignant obstruction and therapies on the detection rate of pathogenic bacteria in bile was analyzed,and the detection rate of pathogenic bacteria in bile and blood was compared.The chi- square test was used for comparison of categorical data between groups.Results Pathogenic bacteria were detected in246 patients( 246 /322),resulting in a detection rate of 76.40%.A total of 267 strains were detected,which consisted of 208 strains of Gram- negative bacteria,48 strains of Gram- positive bacteria,and 11 strains of fungi.Among the 256 patients who underwent endoscopic retrograde cholangiopancreatography( ERCP),199 were detected to have pathogenic bacteria,resulting in a detection rate of 77.73%;among the 66 patients who underwent surgery,47 were detected to have pathogenic bacteria,resulting in a detection rate of 71.21%.There was no significant difference in the detection rate of pathogenic bacteria between these two groups( χ~2= 1.238,P = 0.266).Among the 288 patients with benign obstructive jaundice,215 were detected to have pathogenic bacteria,resulting in a detection rate of 74.65%;among the34 patients with malignant obstructive jaundice,31 were detected to have pathogenic bacteria,resulting in a detection rate of 91.18%.There was a significant difference in the detection rate of pathogenic bacteria between these two groups( χ~2= 4.605,P = 0.032),and there was a significant difference in the distribution of pathogenic bacteria in bile between these two groups( χ~2= 0.159,P = 0.690).The types of pathogenic bacteria in bile samples were similar to those in blood samples,and there was a significant difference in the detection of pathogenic bacteria between them( χ~2= 13.235,P < 0.001).Conclusion There is no significant difference in the detection rate of pathogenic bacteria determined by ERCP or surgery in patients with obstructive jaundice.For patients who cannot undergo ERCP or surgery,blood culture results can be used to guide clinical medication.