Bacterial Isolates and their Antibiotic Susceptibility in Bile of Patients with Gallstone in Al-Hussein Teaching Hospital


  • Muhanad Abdulretha Dept. Surgery\college of medicine\University of Thi-Qar
  • Saad A. Atiyah Dept. Microbiology\college of medicine\University of Thi-Qar
  • Abdul-kareem Salman Al-Yassari College of Vet. Med./University of AL-Qasim Green
  • Younus A. Kamel Thi-Qar Directorate of Health


Gallstone, Bacterial Colonization, Flouroquinolones


The bacterial colonization in gallbladder represent important factor in initiation of gallstone and chronic cholecystitis. The aim of the study was to detect the facultative anaerobic bacterial isolates and determination of the most efficient antibiotics in treatment of gallbladder infections. Bile specimens were collected from 62 patients who have suffered from gallstone cultivated on bacteriological media, the diagnosis of isolates and antibiotic susceptibility test for the following antibiotics (CIP,NOR,AK,CN,CTX,CRO,CL,AMC,SXT,AZM and TET) was done by using standard bacteriological techniques. According to results (14.51%) of the examined bile specimens were positive cultures with predominance of E. coli which represent (54.55%) of isolates followed by Enterobacter spp. (18.18%) with high significant differences (P< 0.001), The flouroquinolones (CIP & NOR) were most effective antibiotics followed by aminoglycosides (AK,CN) and CTX under (P< 0.05). Furthermore, the isolates showed high and complete resistance to other antibiotics. In brief, colonization of bacteria may associated with the formation of gallstone where the E. coli is the most frequent bacterial isolates and the flouroquinolones (CIP & NOR) appear to be highly effective against isolated bacteria and may play a role in treatment of infections. 



Abeysuriya, V.,Deen, K.I.,Wijesuriya, T. and Salgado, S.S. (2008). Microbiology of gallbladder bile in uncomplicated symptomatic cholelithiasis. Hepatobiliary Pancreat. Dis. Int. 7(6): 633-637.

Swidsinski, A., Ludwig, W., Pahlig, H. and Priem, F. ( 1995). Molecular genetic evidence of bacterial colonization of cholesterol gallstones. Gastroenterology. ;108(3):860-4.

Cotran, R., Kumar, V., Collins, T., Robbins, S. and Schmitt, B. (1999).Robbins’Pathologic Basis of Disease. 6th ed. Boston: WB Saunders, 1999:454-478.

Maki, T. (1966). Pathogenesis of calcium bilirubinate gallstone: role of E. coli, beta-glucuronidase. and coagulation by inorganic ions, polyelectrolytes and agitation.. Ann. Surg. 164(1):90-100.

Portincasa, P., Moschetta, A. and Palasciano, G. (2006). Cholesterol gallstone disease.Lancet. 368(9531):230-239.

Alexander, S., Wolfgang, L., Hartmut, P. and Friedrich, P. (1995). Molecular genetic evidence of bacterial colonization of cholesterol gallstones.Gastroenterology. 108(3):860-864.

Hazrah, P., Oahn, K.T., Tewari, M., Pandey, A.K., Kumar, K., Mohapatra, T.M. and Shukla, H.S. (2004). The frequency of live bacteria in gallstones.HPB (Oxford). 6(1):28-32.

Stewart, L., Grifiss, J.M., Jarvis, G.A. andWay, L.W. (2006). Biliary bacterial factors determine the path of gallstone formation. Am. J. Surg. 192(5):598-603.

Gonzalez-Escobedo, G., Marshall, J.M. and Gunn. J.S.(2011). Chronic and acute infection of the gall bladder by Salmonella Typhi: understanding the carrier state. Nat Rev Microbiol. 9(1): 9–14.

Swidsinski, A. and Lee, S.P. (2001). The role of bacteria in gallstone pathogenesis. Front Biosci. 6: 93-103.

Cheng, H.Y., Yang, H.Y. and Chou, C.C.. Influence of acid adaptation on the tolerance of Escherichia coli O157:H7 to some subsequent stresses. J Food Prot 2002; 65: 260-265.

Mendes, C., Hsiung, A., Kiffer, C., Oplustil, C., Sinto, S., Mimica, I. and Zoccoli, C. (2000). Evaluation of the in vitro activity of 9 antimicrobials against bacterial strains isolated from patients in intensive care units in Brazil: MYSTIC Antimicrobial Surveillance Program. Braz. J. Infect. Dis. 4:236-244.

Collee, J.G., Fraser, A. G., Marmion, B. P. and Simmon, A. (1996). Makic and McCartncy medical microbiology. 14th. the Churchill living stone.

Baron, E. J. ; Peterson, L. P. and Fengold, S. M. (1994) . Diagnostic Microbiology . 9 thed . Mosby

Clinical and Laboratory Standards Institute . (2014). Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fourth Informational Supplement.

Leung, J.W., Sung, J.Y. and Costerton, J.W. (1989). Bacteriological and electron microscopy examination of brown pigment stones. J. Clin. Microbiol. 27:915–921.

Capoor, M.R. (2008). Microflora of bile aspirates in patients with acute cholecystitis with or without cholelithiasis: a tropical experience. Braz. J Infect. Dis. 12:222-225

Crawford, R., Rosales-Reyes, R., Ramírez-Aguilar, M.L., Chapa-Azuela, O., Alpuche-Aranda, S. and Gunn, J.S. (2010). Gallstones play a significant role in Salmonella spp. gallbladder colonization and carriage. Nat. Acad. Sci. USA. 107 (9).

. Costerton, J. W.; Stewart, P. S. and Greenberg, E. P. (1999) . Bacterial biofilm : A common cause of persistent infections . Science . 248: 1318-1322.

Stewart, P. S. (2002) . Mechanism of antibiotic resistance in bacterial biofilms . Int. J. Med. Microbiol. 292: 107-113.

Ledeboer, N.A. and Jones, B.D. (2005).Exopolysaccharide sugars contribute to biofilm formation by Salmonella enterica serovar Typhimurium on HEp-2 cells and chicken intestinal epithelium. J. Bacteriol. 187:3214–3226.

Fatemi, S., Doosti, A., Tavakoli,

H., Moayednia, R., Ghasemi-Dehkordi, P., Kelidari, B., Mahmudieh, M. and Moayednia, M. (2015). Antibiotic susceptibility patterns of isolated bacteria from bile fluids of patients with gallstone disease in Isfahan (Iran). Arch. Biol. Sci. Belgrade. 67(2), 611-617

Ballal, M., Jyothi, K. N., Antony, B., Arun, C., Prabhu, T. and Shivananda, P.G. (2001). Bacteriological spectrum of cholecystitis and its antibiogram. Indian J. Med. Microbiol. 19(4),212-214.