{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T18:53:16Z","timestamp":1784919196579,"version":"3.55.0"},"reference-count":19,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T00:00:00Z","timestamp":1730332800000},"content-version":"unspecified","delay-in-days":30,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,9,30]]},"published-print":{"date-parts":[[2024,10]]},"abstract":"Introduction<\/jats:title>Bile fluid is aseptic under normal conditions; however, in the presence of cholecystitis, its susceptibility to bacterial colonisation varies, with reported rates of 20%\u201370% of cases. This process is referred to as bactibilia and\/or bacteriobilia and can be considered a secondary complication of biliary stasis and cholecystitis in general. In the management of acute cholecystitis, the antibiotic regimen should be prescribed based on the presumed pathogens involved, taking into consideration the risk factors for resistance patterns according to demographics and local exposure. The aim of this study is to determine the predictive factors for bile culture positivity and antibiotic resistance in patients who underwent laparoscopic cholecystectomy in the M\u00e9deri Hospital Network. We hope to develop a predictive model that allows us to better guide antibiotic therapy.<\/jats:p><\/jats:sec>Methods and analysis<\/jats:title>This is a prospective observational cohort study with prognostic prediction model. Patients who will undergo laparoscopic cholecystectomy and have bile cultures taken in the M\u00e9deri Hospital Network during the study period will be included. The dependent variables will be positive bile culture and antibiotic resistance, and the predictive variables will be age, presence of diabetes, diagnosis of choledocholithiasis, diagnosis of cholecystitis and severity of cholecystitis according to the Tokyo criteria. The minimum sample size has been calculated at 703 patients. Follow-up will continue until a control appointment 15 days after the procedure. The primary outcomes are bile culture positivity and phenotypical antibiogram resistance. For each outcome, a multivariate logistic regression will be performed using frequentist and Bayesian prediction techniques.<\/jats:p><\/jats:sec>Ethics and dissemination<\/jats:title>This study was approved by the M\u00e9deri network research department committee (CIMED) and by Universidad del Rosario\u2019s Research Ethics Committee (CEI-UR; DVO005 2555-CV1837). Written informed consent is required for participation. The results will be disseminated through the submission of an academic article to a high-impact scientific journal, presentations at academic conferences, and sharing with our institution's faculty to inform antimicrobial therapy management based on local epidemiological data.<\/jats:p><\/jats:sec>Trial registration number<\/jats:title>NCT06314399<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2024-086655","type":"journal-article","created":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T10:00:38Z","timestamp":1730455238000},"page":"e086655","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Predictive factors associated with Bile culture positivity And phenotypiCal antIbiogram resistance patterns in patients taken to LaparOscopic cholecystectomy (BACILO): protocol for a prospective observational cohort study and development of a prognostic prediction model"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct06314399","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct06314399","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1929-2299","authenticated-orcid":false,"given":"Camilo","family":"Ram\u00edrez-Giraldo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Rodriguez Barbosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Isaza-Restrepo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Violeta","family":"Avenda\u00f1o-Morales","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Rojas-L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Van-Londo\u00f1o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,11,1]]},"reference":[{"key":"2024110103001357000_14.10.e086655.1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.jinf.2019.09.015","article-title":"Bacteria and fungi in acute cholecystitis. A prospective study comparing next generation sequencing to culture","volume":"80","author":"Dyrhovden","year":"2020","journal-title":"J Infect"},{"key":"2024110103001357000_14.10.e086655.2","doi-asserted-by":"crossref","unstructured":"Pisano M , Allievi N , Gurusamy K , et al . 2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis. World J Emerg Surg 2020;15. doi:10.1186\/s13017-020-00336-x","DOI":"10.1186\/s13017-020-00336-x"},{"key":"2024110103001357000_14.10.e086655.3","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1186\/s12874-020-01050-7","article-title":"A conceptual framework for prognostic research","volume":"20","author":"Kent","year":"2020","journal-title":"BMC Med Res Methodol"},{"key":"2024110103001357000_14.10.e086655.4","unstructured":"Collins GS , Moons KGM , Dhiman P , et al . TRIPOD+AI statement: updated guidance for reporting clinical prediction models that use regression or machine learning methods. 2024. Available: https:\/\/www.bmj.com\/content\/385\/bmj-2023-078378"},{"key":"2024110103001357000_14.10.e086655.5","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1016\/j.hpb.2023.01.017","article-title":"Suggested use of empirical antibiotics in acute cholecystitis based on bile microbiology and antibiotic susceptibility","volume":"25","author":"Lee","year":"2023","journal-title":"HPB (Oxf)"},{"key":"2024110103001357000_14.10.e086655.6","doi-asserted-by":"crossref","first-page":"253","DOI":"10.22354\/in.v23i3.789","article-title":"Biliary tract infections and their Microbiological Spectrum- A study from coastal region of Southern India","volume":"23","author":"Mamatha","year":"2019","journal-title":"Infect"},{"key":"2024110103001357000_14.10.e086655.7","doi-asserted-by":"crossref","unstructured":"Galili O , Eldar S , Matter I , et al . The effect of bactibilia on the course and outcome of laparoscopic cholecystectomy. Eur J Clin Microbiol Infect Dis 2008.","DOI":"10.1007\/s10096-008-0504-8"},{"key":"2024110103001357000_14.10.e086655.8","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-021-91261-9","article-title":"Clinical implication of bactibilia in moderate to severe acute cholecystitis undergone cholecystostomy following cholecystectomy","volume":"11","author":"Yoon","year":"2021","journal-title":"Sci Rep"},{"key":"2024110103001357000_14.10.e086655.9","doi-asserted-by":"crossref","first-page":"145","DOI":"10.4240\/wjgs.v7.i8.145","article-title":"Single-port laparoscopic cholecystectomy vs standard laparoscopic cholecystectomy: A non-randomized, age-matched single center trial","volume":"7","author":"van der Linden","year":"2015","journal-title":"World J Gastrointest Surg"},{"key":"2024110103001357000_14.10.e086655.10","unstructured":"Rhodes A , Evans LE , Alhazzani W , et al . Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016, Available: https:\/\/pubmed.ncbi.nlm.nih.gov\/28098591\/"},{"key":"2024110103001357000_14.10.e086655.11","doi-asserted-by":"crossref","unstructured":"Gomi H , Okamoto K , Ukai T , et al . Response to Re: Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis. J Hepato Biliary Pancreat 2018;25. doi:10.1002\/jhbp.560","DOI":"10.1002\/jhbp.560"},{"key":"2024110103001357000_14.10.e086655.12","unstructured":"Wu Z , Wu X , Yao W , et al . Pathogens\u2019 distribution and changes of antimicrobial resistance in the bile of acute biliary tract infection patients. Zhonghua Wai Ke Za Zhi [Internet] 2021;59. 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Bogot\u00e1: Universidad del Rosario, 2016."},{"key":"2024110103001357000_14.10.e086655.16","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1007\/s11605-021-05182-z","article-title":"Intraoperative Bile Culture in Pancreaticoduodenectomy: Teaching Old Dogma New Tricks","volume":"26","author":"Sutton","year":"2022","journal-title":"J Gastrointest Surg"},{"key":"2024110103001357000_14.10.e086655.17","doi-asserted-by":"crossref","first-page":"2426","DOI":"10.1007\/s00268-021-06107-2","article-title":"The Bacteriology of Acute Cholecystitis: Comparison of Bile Cultures and Clinical Outcomes in Diabetic and Non\u2010Diabetic Patients","volume":"45","author":"Kaplan","year":"2021","journal-title":"World j surg"},{"key":"2024110103001357000_14.10.e086655.18","doi-asserted-by":"crossref","DOI":"10.1016\/j.amsu.2021.102822","article-title":"Biliary infection; distribution of species and antibiogram study","volume":"70","author":"Shafagh","year":"2021","journal-title":"Ann Med Surg (Lond)"},{"key":"2024110103001357000_14.10.e086655.19","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/jgh.14809","article-title":"Increasing burden of biliary tract infection caused by extended\u2010spectrum beta\u2010lactamase\u2010producing organisms in Korea: A nationwide population\u2010based study","volume":"35","author":"Jang","year":"2020","journal-title":"J of Gastro and Hepatol"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-086655","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T10:00:46Z","timestamp":1730455246000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-086655"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":19,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,11,1]]},"published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1136\/bmjopen-2024-086655"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-086655","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10]]}}}