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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MDPI AG
2025-07-01
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| Series: | Antibiotics |
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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. |
| format | Article |
| id | doaj-art-13047d58732f4e19844e6a17469605bc |
| institution | Kabale University |
| issn | 2079-6382 |
| language | English |
| publishDate | 2025-07-01 |
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| series | Antibiotics |
| 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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