Bacterial Identification in Bile and Blood of Patients with Acute Cholangitis from Benign and Malignant Bile Duct Obstruction

Background/Aims: The purpose of the present study was to identify the major bacterial organisms in the patients with cholangitis due to benign and malinant bile duct obstruction. Methods: Bacterial culture was undertaken in the bile and blood specimens from eighty-three patients with acute cholangitis due to benign (n=58) or malignant (n=25) bile duct obstruction. Results: Bacteria were detected in 96.3% of bile and 80.0% of blood samples. We isolated 78 strains from 58 bile specimens and 54 strains from 51 blood samples of the patients with benign cholangitis. The major isolates were Escherichia coli and Klebsiella spp.. In the patients with malignant cholangitis, 35 strains and 26 strains were isolated from 25 bile specimens and 24 blood samples, respectively, and Pseudomonas aeruginosa and E. coli were prevalent. Two or more bacterial strains were isolated simultaneously in 19 (32.8%) of 58 benign bile duct obstruction and in 11 (44.0%) of 25 malignanct bile duct obstruction. Conclusions: Bacteria play a major role in the pathogenesis of acute cholangitis of malignancy as well as benign bile duct obstruction.