Microbial Profile and Antibiotic Resistance Patterns in Bile Aspirates from Patients with Acute Cholangitis: A Multicenter International Study

Objectives: Significant differences in antibiotic resistance (AR) rates and multi-drug resistant (MDR) bacteria incidence exist in patients with acute cholangitis (AC) from different countries or regions. We aim to characterize and compare the microbial spectrum and AR patterns in patients with AC f...

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Main Authors: Matei-Alexandru Cozma, Mihnea-Alexandru Găman, Camelia Cristina Diaconu, Arthur Berger, Frank Zerbib, Radu Bogdan Mateescu
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Antibiotics
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Online Access:https://www.mdpi.com/2079-6382/14/7/679
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author Matei-Alexandru Cozma
Mihnea-Alexandru Găman
Camelia Cristina Diaconu
Arthur Berger
Frank Zerbib
Radu Bogdan Mateescu
author_facet Matei-Alexandru Cozma
Mihnea-Alexandru Găman
Camelia Cristina Diaconu
Arthur Berger
Frank Zerbib
Radu Bogdan Mateescu
author_sort Matei-Alexandru Cozma
collection DOAJ
description Objectives: Significant differences in antibiotic resistance (AR) rates and multi-drug resistant (MDR) bacteria incidence exist in patients with acute cholangitis (AC) from different countries or regions. We aim to characterize and compare the microbial spectrum and AR patterns in patients with AC from two tertiary centers in Europe. Methods: We conducted a prospective, observational, multicentric study including patients diagnosed with AC and a positive bile culture, admitted to the Colentina Clinical Hospital (CCH), Bucharest, Romania, and the Haut-Lévêque Hospital (HLH), Bordeaux, France, between April 2022 and October 2023. Results: We included a total of 144 patients from the CCH with 190 positive bile cultures (31 patients had up to five episodes of AC during the study period) and 241 identified microbial strains, and 62 patients from the HLH with 67 positive bile cultures (5 patients had two episodes of AC) and 194 identified microbial strains. The most frequently isolated bacteria were <i>Escherichia coli</i> (30.70%) and <i>Pseudomonas</i> spp. (27.80%) in the CCH group, and <i>Enterococcus faecalis</i> (15.46%) and <i>Escherichia coli</i> (22/11.34%) in the HLH group. Furthermore, 51 (21.16%) of the strains identified in the CCH group and 15 (7.21%) in the HLH group were MDR, such as extended-spectrum beta-lactamase-producing <i>Enterobacteriaceae</i> or carbapenemase-producing <i>Enterobacterales</i>. The resistance rates for common antibiotics were 13.69% in the CCH group vs. 8.76% in the HLH group for ceftriaxone, 9.54% vs. 2.06% for meropenem, 16.59% vs. 6.70% for piperacillin/tazobactam, and 25.31% vs. 7.73% for levofloxacin. Conclusions: This comparative study shows significant differences between these countries in terms of the AR rates and MDR bacteria prevalence, highlighting the role of bile cultures as a safe and cost-effective method for guiding antibiotic treatment, thereby reducing the AR rates and complications.
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spelling doaj-art-13047d58732f4e19844e6a17469605bc2025-08-20T03:55:48ZengMDPI AGAntibiotics2079-63822025-07-0114767910.3390/antibiotics14070679Microbial Profile and Antibiotic Resistance Patterns in Bile Aspirates from Patients with Acute Cholangitis: A Multicenter International StudyMatei-Alexandru Cozma0Mihnea-Alexandru Găman1Camelia Cristina Diaconu2Arthur Berger3Frank Zerbib4Radu Bogdan Mateescu5Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Hematology, Center for Clinical and Basic Research (CCBR Clinic), 030463 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaHaut-Lévêque Hospital, Centre Hospitalier Universitaire de Bordeaux, 33600 Pessac, FranceHaut-Lévêque Hospital, Centre Hospitalier Universitaire de Bordeaux, 33600 Pessac, FranceFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaObjectives: Significant differences in antibiotic resistance (AR) rates and multi-drug resistant (MDR) bacteria incidence exist in patients with acute cholangitis (AC) from different countries or regions. We aim to characterize and compare the microbial spectrum and AR patterns in patients with AC from two tertiary centers in Europe. Methods: We conducted a prospective, observational, multicentric study including patients diagnosed with AC and a positive bile culture, admitted to the Colentina Clinical Hospital (CCH), Bucharest, Romania, and the Haut-Lévêque Hospital (HLH), Bordeaux, France, between April 2022 and October 2023. Results: We included a total of 144 patients from the CCH with 190 positive bile cultures (31 patients had up to five episodes of AC during the study period) and 241 identified microbial strains, and 62 patients from the HLH with 67 positive bile cultures (5 patients had two episodes of AC) and 194 identified microbial strains. The most frequently isolated bacteria were <i>Escherichia coli</i> (30.70%) and <i>Pseudomonas</i> spp. (27.80%) in the CCH group, and <i>Enterococcus faecalis</i> (15.46%) and <i>Escherichia coli</i> (22/11.34%) in the HLH group. Furthermore, 51 (21.16%) of the strains identified in the CCH group and 15 (7.21%) in the HLH group were MDR, such as extended-spectrum beta-lactamase-producing <i>Enterobacteriaceae</i> or carbapenemase-producing <i>Enterobacterales</i>. The resistance rates for common antibiotics were 13.69% in the CCH group vs. 8.76% in the HLH group for ceftriaxone, 9.54% vs. 2.06% for meropenem, 16.59% vs. 6.70% for piperacillin/tazobactam, and 25.31% vs. 7.73% for levofloxacin. Conclusions: This comparative study shows significant differences between these countries in terms of the AR rates and MDR bacteria prevalence, highlighting the role of bile cultures as a safe and cost-effective method for guiding antibiotic treatment, thereby reducing the AR rates and complications.https://www.mdpi.com/2079-6382/14/7/679acute cholangitisantimicrobial resistancebile culturesmultidrug-resistant bacteria
spellingShingle Matei-Alexandru Cozma
Mihnea-Alexandru Găman
Camelia Cristina Diaconu
Arthur Berger
Frank Zerbib
Radu Bogdan Mateescu
Microbial Profile and Antibiotic Resistance Patterns in Bile Aspirates from Patients with Acute Cholangitis: A Multicenter International Study
Antibiotics
acute cholangitis
antimicrobial resistance
bile cultures
multidrug-resistant bacteria
title Microbial Profile and Antibiotic Resistance Patterns in Bile Aspirates from Patients with Acute Cholangitis: A Multicenter International Study
title_full Microbial Profile and Antibiotic Resistance Patterns in Bile Aspirates from Patients with Acute Cholangitis: A Multicenter International Study
title_fullStr Microbial Profile and Antibiotic Resistance Patterns in Bile Aspirates from Patients with Acute Cholangitis: A Multicenter International Study
title_full_unstemmed Microbial Profile and Antibiotic Resistance Patterns in Bile Aspirates from Patients with Acute Cholangitis: A Multicenter International Study
title_short Microbial Profile and Antibiotic Resistance Patterns in Bile Aspirates from Patients with Acute Cholangitis: A Multicenter International Study
title_sort microbial profile and antibiotic resistance patterns in bile aspirates from patients with acute cholangitis a multicenter international study
topic acute cholangitis
antimicrobial resistance
bile cultures
multidrug-resistant bacteria
url https://www.mdpi.com/2079-6382/14/7/679
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