{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T08:06:13Z","timestamp":1784880373103,"version":"3.55.0"},"reference-count":30,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Objectives: To evaluate bile culture microbiology and factors associated with resistance patterns in patients taken to laparoscopic cholecystectomy to better guide empiric antibiotic therapy. Methods: Prospective cohort study with a logistic regression model in a middle-income public hospital network of two institutions. Inclusion criteria were patients taken to laparoscopic cholecystectomy over 18 years of age due to benign biliary disease without other concomitant surgical procedures taken to bile culture and antibiogram testing to evaluate bile culture positivity considered as a \u201cresistant pattern\u201d. Results: 226 cultures tested positive for at least one microorganism, and 218 were included in the study. Overall, bile cultures classified as resistant were associated with age, comorbidities, acute signs of cholecystitis, and longer antibiotic therapy. Bile microorganisms found consisted mostly of Enterobacteriaceae. In the logistic regression model, previous ERCP, Charlson comorbidity index and duration of antibiotic therapy yielded as statistically significant (p 0.03, p 0.003 and 0.004, respectively) for presenting resistant patterns. Conclusions: Patients taken to laparoscopic cholecystectomy have a higher probability of being resistant to empirical therapy for managing acute cholecystitis if they had a higher Charlson comorbidity index, previous ERCP and longer preoperative antibiotic therapy, and thus intraoperative cultures should be considered for guided antibiotic therapy. Trial registration number: NCT06314399.<\/jats:p>","DOI":"10.3390\/antibiotics15080717","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T07:36:13Z","timestamp":1784878573000},"page":"717","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bile Microbiology and Risk Factors Associated with Antibiotic Resistance Patterns in Patients Taken to Laparoscopic Cholecystectomy: A Prospective Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2582-7138","authenticated-orcid":false,"given":"Isabella","family":"Van-Londo\u00f1o","sequence":"first","affiliation":[{"name":"Hospital Universitario Mayor-M\u00e9deri, Bogot\u00e1 111411, Colombia"},{"name":"Grupo de Investigaci\u00f3n Cl\u00ednica, Universidad del Rosario, Bogot\u00e1 110221, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1929-2299","authenticated-orcid":false,"given":"Camilo","family":"Ram\u00edrez-Giraldo","sequence":"additional","affiliation":[{"name":"Hospital Universitario Mayor-M\u00e9deri, Bogot\u00e1 111411, Colombia"},{"name":"Grupo de Investigaci\u00f3n Cl\u00ednica, Universidad del Rosario, Bogot\u00e1 110221, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Moreno-Martinez","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n Cl\u00ednica, Universidad del Rosario, Bogot\u00e1 110221, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8302-2867","authenticated-orcid":false,"given":"Carlos","family":"Rodriguez-Barbosa","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n Cl\u00ednica, Universidad del Rosario, Bogot\u00e1 110221, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Gabriela","family":"Robayo-Romero","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n Cl\u00ednica, Universidad del Rosario, Bogot\u00e1 110221, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3888-6316","authenticated-orcid":false,"given":"Eliana","family":"Maldonado","sequence":"additional","affiliation":[{"name":"Hospital Universitario Mayor-M\u00e9deri, Bogot\u00e1 111411, Colombia"},{"name":"Grupo de Investigaci\u00f3n Cl\u00ednica, Universidad del Rosario, Bogot\u00e1 110221, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Rojas L\u00f3pez","sequence":"additional","affiliation":[{"name":"Hospital Universitario Mayor-M\u00e9deri, Bogot\u00e1 111411, Colombia"},{"name":"Grupo de Investigaci\u00f3n Cl\u00ednica, Universidad del Rosario, Bogot\u00e1 110221, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1569-969X","authenticated-orcid":false,"given":"Andr\u00e9s","family":"Isaza-Restrepo","sequence":"additional","affiliation":[{"name":"Hospital Universitario Mayor-M\u00e9deri, Bogot\u00e1 111411, Colombia"},{"name":"Grupo de Investigaci\u00f3n Cl\u00ednica, Universidad del Rosario, Bogot\u00e1 110221, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"ref_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":"ref_2","first-page":"257","article-title":"Factors that influence bile fluid microbiology in cholecystectomized patients","volume":"85","year":"2020","journal-title":"Rev. Gastroenterol. M\u00e9xico (Engl. Ed.)"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1007\/s15010-013-0415-1","article-title":"Bile microbiology at a hospital in southern Taiwan","volume":"41","author":"Kuo","year":"2013","journal-title":"Infection"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s15010-012-0358-y","article-title":"Changing trend in bile microbiology and antibiotic susceptibilities: Over 12 years of experience","volume":"41","author":"Kwon","year":"2013","journal-title":"Infection"},{"key":"ref_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"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1002\/jhbp.516","article-title":"Tokyo guidelines 2018: Flowchart for the management of acute cholecystitis","volume":"25","author":"Okamoto","year":"2018","journal-title":"J. Hepato-Biliary Pancreat. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/jhbp.518","article-title":"Tokyo Guidelines 2018: Antimicrobial therapy for acute cholangitis and cholecystitis","volume":"25","author":"Gomi","year":"2018","journal-title":"J. Hepato-Biliary Pancreat. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e086655","DOI":"10.1136\/bmjopen-2024-086655","article-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","volume":"14","year":"2024","journal-title":"BMJ Open"},{"key":"ref_9","first-page":"1157","article-title":"Predictive factors associated with bile culture positivity: A model development and diagnostic test accuracy study","volume":"40","year":"2025","journal-title":"Surg. Endosc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: Building an international community of software platform partners","volume":"95","author":"Harris","year":"2019","journal-title":"J. Biomed. Inform."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3151","DOI":"10.1097\/JS9.0000000000001268","article-title":"The STROCSS 2024 guideline: Strengthening the reporting of cohort, cross-sectional, and case-control studies in surgery","volume":"110","author":"Rashid","year":"2024","journal-title":"Int. J. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Farhana, N., Ashraf, M., Khan, U., and Shamsuzzaman, S.M. (2024). Antibiotic Resistance pattern in Bile from Cholecystectomised Patients by Multiplex PCR. bioRxiv.","DOI":"10.1101\/2024.06.25.600685"},{"key":"ref_13","first-page":"373","article-title":"Microbiological etiology and current resistance patterns in acute calculous cholecystitis","volume":"102","year":"2024","journal-title":"Cirug\u00eda Espa\u00f1ola (Engl. Ed.)"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Miutescu, B., Vuletici, D., Burciu, C., Bende, F., Ratiu, I., Moga, T., Gadour, E., Reddy, S., Sandru, V., and Balan, G. (2024). Comparative Analysis of Microbial Species and Multidrug Resistance Patterns in Acute Cholangitis Patients with Cholecystectomy: A Single-Center Study. Diseases, 12.","DOI":"10.3390\/diseases12010019"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e11234","DOI":"10.1097\/MD.0000000000011234","article-title":"Clinical aspects of bile culture in patients undergoing laparoscopic cholecystectomy","volume":"97","author":"Yun","year":"2018","journal-title":"Medicine"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"10","DOI":"10.4174\/astr.2023.104.1.10","article-title":"Incidence of bactibilia and related factors in patients who undergo cholecystectomy","volume":"104","author":"Moon","year":"2023","journal-title":"Ann. Surg. Treat. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1007\/s10096-008-0504-8","article-title":"The effect of bactibilia on the course and outcome of laparoscopic cholecystectomy","volume":"27","author":"Galili","year":"2008","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1080\/13651820701275105","article-title":"Microbiological assessment of bile during cholecystectomy: Is all bile infected?","volume":"9","author":"Ogunbiyi","year":"2007","journal-title":"HPB"},{"key":"ref_19","first-page":"759","article-title":"Microorganisms isolated from the bile of the patients who have undergone cholecystectomy and their antibiotic resistance pattern: Multicenter prospective study","volume":"25","author":"Agalar","year":"2022","journal-title":"Int. Microbiol. Off. J. Span. Soc. Microbiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1080\/1120009X.2024.2381158","article-title":"Aminoglycoside antibiotics as first-line treatment of acute appendicitis and cholecystitis","volume":"37","author":"Pintar","year":"2025","journal-title":"J. Chemother."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1093\/aje\/kwi068","article-title":"Utility of the Chronic Disease Score and Charlson Comorbidity Index as comorbidity measures for use in epidemiologic studies of antibiotic-resistant organisms","volume":"161","author":"McGregor","year":"2005","journal-title":"Am. J. Epidemiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e000695","DOI":"10.1136\/bmjgast-2021-000695","article-title":"Bacteraemia, sepsis and antibiotic resistance in Australian patients with cirrhosis: A population-based study","volume":"8","author":"Johnson","year":"2021","journal-title":"BMJ Open Gastroenterol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"R142","DOI":"10.1186\/cc7119","article-title":"Determinants and impact of multidrug antibiotic resistance in pathogens causing ventilator-associated-pneumonia","volume":"12","author":"Depuydt","year":"2008","journal-title":"Crit. Care"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Fico, V., La Greca, A., Tropeano, G., Di Grezia, M., Chiarello, M.M., Brisinda, G., and Sganga, G. (2024). Updates on Antibiotic Regimens in Acute Cholecystitis. Medicina, 60.","DOI":"10.3390\/medicina60071040"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1308\/003588414X13946184900688","article-title":"A national audit of antibiotic prophylaxis in elective laparoscopic cholecystectomy","volume":"96","author":"Graham","year":"2014","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1002\/bjs.1800770315","article-title":"Meta-analysis of randomized, controlled clinical trials of antibiotic prophylaxis in biliary tract surgery","volume":"77","author":"Meijer","year":"1990","journal-title":"Br. J. Surg."},{"key":"ref_27","first-page":"CD003543","article-title":"Interventions to improve antibiotic prescribing practices for hospital inpatients","volume":"30","author":"Davey","year":"2013","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1996","DOI":"10.1056\/NEJMoa1411162","article-title":"Trial of Short-Course Antimicrobial Therapy for Intraabdominal Infection","volume":"372","author":"Sawyer","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"18","DOI":"10.4140\/TCP.n.2025.18","article-title":"Antibiotic Length of Therapy: Is Shorter Better in Older Adults?","volume":"40","author":"Hemenway","year":"2025","journal-title":"Sr. Care Pharm."},{"key":"ref_30","first-page":"e58883","article-title":"Efficacy of Short-Course Antibiotic Therapy for Acute Cholangitis with Positive Blood Cultures: A Retrospective Study","volume":"16","author":"Masuda","year":"2024","journal-title":"Cureus"}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/8\/717\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T07:59:43Z","timestamp":1784879983000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/8\/717"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,24]]},"references-count":30,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["antibiotics15080717"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics15080717","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,24]]}}}